Computer-Aided Detection for Tuberculosis (CAD4TB)

Delft’s innovative CAD4TB software is designed to help (non-expert) readers detect tuberculosis more accurately and cost-effectively. The speed of digital X-rays combined with machine learning and remote expertise make CAD4TB a valuable asset in the fight against TB.

Need for a Affordable, Quick and Easy Remote Solution

Most countries where TB is widespread are poor; its prevalence is highest in countries with the lowest per-capita GDP. It is, therefore, not surprising that one of the main reasons TB incidences have not significantly decreased is the lack of simple, effective and inexpensive ways to detect new TB cases at an early stage. While the only way to diagnose TB is with a test like GeneXpert, these tests are expensive.

The World Health Organization (WHO) has recommended digital chest X-rays for systematic TB screening, which can show abnormalities in the lungs that suggest a patient may have TB. Although X-rays require local expertise for accurate reading, they have low operational costs and quick results.

CAD4TB Imaging Software

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Software to Detect TB

Delft Imaging Systems has solved the TB detection challenge by combining low-cost, quick digital X-rays with machine learning and remote expertise. It’s called CAD4TB, Computer-Aided Detection for Tuberculosis.

If CAD4TB indicates that TB is likely present in a patient, a follow-up test like GeneXpert can be administered. This way, a patient can be diagnosed and treated within one day.

Diagnosis and treatment within one day.

How CAD4TB Works

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 machine learning to thousands of healthy and diseased X-rays from over 15 countries. CAD4TB also received expert feedback from lung specialists, making it extremely accurate and reliable.

Scoring the Likelihood of Active TB

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.

Our CAD4TB software is EC 0344 certified. 

Download the EC certificate (PDF)

Within 1 minute, 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.

Play this video to see how CAD4TB works

Delft Projects Using CAD4TB


Travel distance to a health facility makes it hard for people to access the healthcare they need. Two mobile OneStopTB clinics are visiting communities to screen people on TB. Patients can now receive the proper diagnosis. Infected people can receive treatment the same day.


We provided as many as 7 OneStopTB clinics, making this our biggest OneStopTB project in East-Africa yet. All 7 OneStopTB clinics have an X-ray compartment with a control room, a separate laboratory for the GeneXpert test (both air-conditioned), teleradiology and computers with our CAD4TB software.


Tuberculosis is one of the leading health issues in Pakistan. More than 350.000 TB cases were notified in 2016. Pakistan is a highly populated country and since tuberculosis is a very infectious disease, it can spread quickly.

South Africa – Prison

Because of overcrowding and poor living conditions, mines and jails are considered breeding grounds for TB – South Africa’s biggest killer. To solve this issue, the Aurum Institute, TBHIVCare and RightToCare started screening inmates in South Africa’s Correctional Services.


The population in Ghana suffered from TB at nearly four times the WHO average. But because the country did have a strong record of curing known cases, it was clear that the slow and expensive diagnostic process was creating the problem.

Want to learn more about CAD4TB?

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