CAD4TB
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 41+ countries to screen 8 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 a mortality rate of 1.4 million every year. 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 platform: Enable AI and digitalise TB screening data management
To further support the END-TB strategy by finding the missing cases, Delft has developed additional screening analytics and management tools to enable users to rapidly screen risk groups and support prevalence surveys, and collect all information into one platform. CAD4TB now includes not only artificial intelligence, but also modules for patient registration, symptoms registration (through customisable forms) and patient reporting. Apart from helping to digitalise the TB screening process, the ‘insights’ module featured in the CAD4TB platform provides valuable insights to management on the program, reflecting those screened in the program through distribution in gender, age and CAD4TB scores.
Diagnosis and treatment within one day.
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 thousands of healthy and diseased X-rays from over 15 countries. The latest CAD4TB version have now included cardiomegaly analysis, making it extremely accurate and reliable.
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.
Scientific Support for CAD4TB
Delft’s innovative approach to screening and diagnosing tuberculosis has been supported by many of our colleagues in the scientific community. Learn in-depth evaluations of CAD4TB in various scientific articles: CAD4TB scientific publication list.
Within 5 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 [...]
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 [...]
Nigeria
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.
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.
Mozambique
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.
eSwatini
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.