DOI: 10.5061/dryad.5tb2rbpcv
title: Comparison of different Lunit INSIGHT CXR software versions when reading chest radiographs for tuberculosis

description: New versions of computer-aided detection (CAD) software for chest X-ray
 (CXR) interpretation during tuberculosis (TB) screening are regularly
 released, which purport to have incremental performance gains. We
 independently measured the differences in CAD software performance between
 INSIGHT CXR (Lunit, South Korea) versions 3.1.0.0 and 3.9.0.1. A
 well-characterized Digital Imaging and Communications in Medicine (DICOM)
 test library was compiled using data from a community-based TB screening
 initiative in Ho Chi Minh City, Viet Nam. The performance of Lunit CAD
 software versions was compared by measuring the area under the receiver
 operating characteristic curve (AUC), stratified by key clinical and
 demographic variables and using Xpert MTB/RIF Ultra (Ultra) test results
 as the reference standard. Median abnormality scores were compared using
 the Wilcoxon signed-rank test and performance characteristics were
 compared at selected cut-off thresholds between the two versions. The
 DICOM test library contained 2,708 participants, of whom 10.3% had a
 Mycobacterium tuberculosis (MTB) Positive Ultra test result. The newer
 software version had a significantly higher AUC than its predecessor (AUC
 0.78 vs 0.76, p=0.029), and performed significantly better among people
 with a past history of TB (AUC 0.73 vs 0.67, p=0.003), older individuals
 (0.75 vs 0.77, p=0.040) and males (0.73 vs 0.76, p=0.008). The median
 abnormality score was significantly higher for the newer software version
 (0.61 vs 0.35, p&lt;0.001) and if the newer software’s cut-off
 threshold was not optimized, its performance was significantly less
 accurate than its predecessors as the same cut-off threshold. Although
 INSIGHT CXR v3.9.0.1 has significantly improved performance
 characteristics compared to its predecessor, further studies should
 prospectively assess how these performance differences translate into
 real-world improvements during TB screening. As new CAD software versions
 are rolled out, the selection of a cut-off threshold must be assessed and
 re-calibrated to ensure the continued accuracy of CXR interpretation.
description: # Comparison of different Lunit INSIGHT CXR software versions when reading
 chest radiographs for tuberculosis
 [https://doi.org/10.5061/dryad.5tb2rbpcv](https://doi.org/10.5061/dryad.5tb2rbpcv) ## Description of the data and file structure The .csv file contains de-identified participant data. De-identified chest X-ray DICOM files have been uploaded in groups of 250. ### Files and variables #### File: Lunit\_Versions\_-*DICOM\_Library\_01*-\_1003034\_to\_2732725.rar **Description:** Chest X-ray DICOM library - Part 1 (n=250 files) #### File: Lunit\_Versions\_-*DICOM\_Library\_02*-\_2734297\_to\_3530730.rar **Description:** Chest X-ray DICOM library - Part 2 (n=250 files) #### File: Lunit\_Versions\_-*DICOM\_Library\_03*-\_3531827\_to\_4347336.rar **Description:** Chest X-ray DICOM library - Part 3 (n=250 files) #### File: Lunit\_Versions\_-*DICOM\_Library\_04*-\_4352367\_to\_5082196.rar **Description:** Chest X-ray DICOM library - Part 4 (n=250 files) #### File: Lunit\_Versions\_-*DICOM\_Library\_05*-\_5083515\_to\_5812275.rar **Description:** Chest X-ray DICOM library - Part 5 (n=250 files) #### File: Lunit\_Versions\_-*DICOM\_Library\_06*-\_5814656\_to\_6537848.rar **Description:** Chest X-ray DICOM library - Part 6 (n=250 files) #### File: Lunit\_Versions\_-*DICOM\_Library\_07*-\_6539735\_to\_7268214.rar **Description:** Chest X-ray DICOM library - Part 7 (n=250 files) #### File: Lunit\_Versions\_-*DICOM\_Library\_08*-\_7271854\_to\_7947908.rar **Description:** Chest X-ray DICOM library - Part 8 (n=250 files) #### File: Lunit\_Versions\_-*DICOM\_Library\_09*-\_7954206\_to\_8724792.rar **Description:** Chest X-ray DICOM library - Part 9 (n=250 files) #### File: Lunit\_Versions\_-*DICOM\_Library\_10*-\_8724834\_to\_9416014.rar **Description:** Chest X-ray DICOM library - Part 10 (n=250 files) #### File: Lunit\_Versions\_-*DICOM\_Library\_11*-\_9417073\_to\_9999316.rar **Description:** Chest X-ray DICOM library - Part 11 (n=208 files) #### File: Lunit\_Versions\_-\_Dryad\_Data\_Set.csv **Description:** Participant data ##### Variables * pid: unique participant ID * sex: 0; 1 (not defined to avoid inclusion of more than three indirect identifiers) * age_group: 1: 18-54 years; 2: ≥55 years * c (cough): 0/No; 1/Yes * f (fever): 0/No; 1/Yes * wl (weight loss): 0/No; 1/Yes * ns (night sweats): 0/No; 1/Yes * contact (of person with TB): 0/No; 1/Yes * past_tb (past history of TB): 0/No; 1/Yes * dm (diabetes): 0/No; 1/Yes; 99/Don't Know or Refused * hiv: Dropped from data set to avoid inclusion of more than three indirect identifiers * rad_system: 1/JPI Healthcare; 2/DRTECH; 3/Konica Minolta * xpert_result: 0/MTB Negative; 1/MTB Positive * lunit_3100: continuous abnormality score for version 3.1.0.0 * lunit_3901: continuous abnormality score for version 3.9.0.1 ## Code/software DICOM files can be opened by any DICOM viewer client, including MicroDICOM. The participant data are in a .csv format and can be opened in Excel or other statistical programs. ## Access information Data were derived from programmatic active TB case finding initiatives funded by the European Commission’s Horizon 2020 programme, the Stop TB Partnership’s TB REACH initiative and USAID.