Computer-Aided Detection for Tuberculosis

CAD4TB is designed to help (non-expert) readers detect tuberculosis more accurately and cost-effectively. CAD4TB has been used in 45 countries to screen over 9,6 million people.
It is CE-Certified for use on ages 4+, and is available for online and offline use.

Tuberculosis solution

Tuberculosis (TB) is one of the deadliest infectious diseases in the world. It affects over 10 million people with an annual mortality rate of 1.5 million in 2020 . However, when diagnosed in time, TB is generally curable within 6 months. Unfortunately, about one-third of patients fail to receive a quick and accurate diagnosis or effective treatment, making them more likely to die from this curable disease.

Solving the problem of tuberculosis requires a diagnostic solution that is affordable, fast, accurate and easy to implement in resource-constrained and hard-to-reach regions.

The World Health Organization

In March 2021, the WHO recommended the use of Computer Aided-Detection (CAD) software instead of human readers to interpret digital chest X-rays for TB screening and triage. CAD4TB is one of the three products included in the technical evaluation.

CAD4TB meets the WHO’s Target Product Profile (TPP) of triage tests (≥90% sensitivity and ≥70% specificity) and has been extensively used for TB projects worldwide supported by the Global Fund, USAID, Stop TB Partnership / TB REACH, EU and the World Bank.

CAD4TB Software

Password: DemoUser

CAD4TB Platform: provides data governance to contribute to the successful adoption of digital TB screening systems

Evolving from paper-based data collection by digitizing data management under one platform is key to creating an efficient TB screening process. Thus, we introduced CAD4TB Platform with SAM (Screening-Analytics-Management) functionalities as an add-on to the CAD4TB 7 software.

CAD4TB platform provides modules for patient registration, symptoms registration and, patient reporting. It digitizes the TB-screening process and provides valuable and targeted insights for gender, age demographics and CAD4TB scores.

The platform enables users to rapidly screen risk groups and support prevalence surveys while at the same time collecting all information into one platform. Thus, it facilitates and simplifies data governance, to optimize the successful adoption of digital TB screening systems.

The SAM functionalities contribute to data quality and integrity while avoiding data fragmentation. It also enables data access from multiple locations: by providing connectivity with other data systems at the national level, SAM can serve as the first data entry point for health workers at the community level, thereby ensuring that National TB Programs can access aggregated data and dashboards.

Click here to learn about Data-driven TB control with CAD4TB platform

Enables users to rapidly screen risk groups and support prevalence surveys while at the same time collecting all information into one platform.

Deep learning for TB detection

The CAD4TB software starts with a quick inspection of a new X-ray image. It normalizes the image to correct for input from various modalities, and then detects the many different abnormal structures that may be related to TB. The system has been trained in the detection of these abnormalities by applying deep learning to healthy and diseased X-rays from all over the globe. The latest CAD4TB version has also included cardiomegaly analysis.

Active TB Screening

The output of the CAD4TB software is a score between 0 and 100, indicating the likelihood that the subject on the image has active TB. The score also includes a texture heat map overlaying the original X-ray image which indicates abnormalities. Only if the output score is higher than a certain threshold will the patient need a subsequent sputum test to finalize the diagnosis. This process brings down both the cost and the time-to-treatment.


Within 2 seconds, the CAD4TB software analyses a chest X-ray, detects abnormalities and indicates the likelihood that active TB is present. This allows costly TB tests to be used only in suspected cases.

Bi-directional Tuberculosis/COVID-19 Screening

The COVID-19 pandemic is threatening the global goals to fight to end TB by 2030. Thereupon, the importance to implement prioritized mitigation measures and innovations for TB programs have been indicated from across the globe. This includes prioritizing bi-directional screening/testing for TB and COVID-19, using X-ray with CAD (computer-aided detection).

At the start of the pandemic, we developed CAD4COVID which uses the same technical core and quality standard as our proven CAD4TB software. With years of digital X-ray and CAD field implementation expertise, our response to the bi-directional screening equation pertaining to TB and COVID-19 is apparent.

Procuring CAD4TB via GDF Diagnostics Catalogue

The Stop TB Partnership’s Global Drug Facility (GDF) announced the inclusion of ultra-portable digital X-ray systems and software packages for the computer-aided detection (CAD) of tuberculosis (TB) based on AI. These TB combat tools will be made available at a reduced cost to all TB programs around the globe. We are proud to announce that CAD4TB can now be easily procured through the Diagnostics Catalogue of GDF at a pre-negotiated price. Learn more here.

Delft Projects Using CAD4TB

Pakistan – Prison

During a systematic screening in a prison setting in Karachi, Quetta, and Peshawar - Pakistan, 20,557 inmates were screened using CAD4TB with portable X-ray.  1,964 (10%) of them were identified as presumptive TB with [...]

Nigeria – Prison

To tackle an outbreak of TB in Kano Central Correctional Center, KNVC Nigeria deployed OneStop TB Mobile Clinic (WoW: Wellness on Wheels) equipped with digital X-ray, CAD4TB, and GeneXpert to screen 2,000 inmates. Compared to the [...]


PATH intensified its TB case finding mission by using Delft's OneStop Mobile Clinic in the highest TB burden province of Zambia: Copperbelt.  The OneStop Mobile Clinic was deployed to screen 30 TB hotspots across Copperbelt [...]


As a quarter of TB cases are estimated to be missed in 2020, the National Tuberculosis and Leprosy Program of Uganda, used Delft Light with CAD4TB for a TB case finding at health facilities [...]

Nigeria – ACF

Using the Delft Light, KNCV Nigeria implemented Community-Based TB Active Case Finding in the hard-to-reach Delta Region. Within four months, 6,218 adults and children ages 4+ were enrolled. Delft Light & CAD4TB screened 6,218 [...]


In February 2021, we successfully completed the last phase of the Lagos State Ministry of Health project which began in December 2020. Altogether 21 digital x-ray installations, including 3 mobile screening vans, 8 semi-mobile containerized x-ray systems and 10 room installations were made.


Delft Imaging installed 5 Delft Lights with CAD4TB and CAD4COVID which they use for screening migrants at the border and prisons. With the financial support of the Global Fund, SMRU is managing a tuberculosis screening program in the migrant population from Myanmar.

Indonesia – Prison

In collaboration with Fullerton Health, the CAD4TB software was used in several prisons and a factory in Jakarta. Prisoners were first screened on symptoms and in the case symptoms were present that could indicate tuberculosis, a chest X-ray (CXR) was taken in a mobile van.


Delft provided an EasyDR X-ray machine with our Computer Aided Detection for Tuberculosis software (CAD4TB). The X-ray screening on TB and silicosis, audio and other tests will be free of charge for all the migrating mine workers.


Early 2016, the National Tuberculosis Programme of Swaziland ordered a mobile OneStopTB clinic to screen around 100.000 inhabitants in Swaziland. They combined the EasyDR digital X-ray with the innovative CAD4TB software, which allowed for an instant triage of suspects. Besides this Delft delivered two EasyPortable X-rays to reach the remotest areas in the mountainous country.

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