  Accurate pulmonary nodule detection is a crucial step in lung cancer
screening. Computer-aided detection (CAD) systems are not routinely used by
radiologists for pulmonary nodule detection in clinical practice despite their
potential benefits. Maximum intensity projection (MIP) images improve the
detection of pulmonary nodules in radiological evaluation with computed
tomography (CT) scans. Inspired by the clinical methodology of radiologists, we
aim to explore the feasibility of applying MIP images to improve the
effectiveness of automatic lung nodule detection using convolutional neural
networks (CNNs). We propose a CNN-based approach that takes MIP images of
different slab thicknesses (5 mm, 10 mm, 15 mm) and 1 mm axial section slices
as input. Such an approach augments the two-dimensional (2-D) CT slice images
with more representative spatial information that helps discriminate nodules
from vessels through their morphologies. Our proposed method achieves
sensitivity of 92.67% with 1 false positive per scan and sensitivity of 94.19%
with 2 false positives per scan for lung nodule detection on 888 scans in the
LIDC-IDRI dataset. The use of thick MIP images helps the detection of small
pulmonary nodules (3 mm-10 mm) and results in fewer false positives.
Experimental results show that utilizing MIP images can increase the
sensitivity and lower the number of false positives, which demonstrates the
effectiveness and significance of the proposed MIP-based CNNs framework for
automatic pulmonary nodule detection in CT scans. The proposed method also
shows the potential that CNNs could gain benefits for nodule detection by
combining the clinical procedure.
