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Fig 1.

Flow diagram for patient selection.

The diagram shows the initial case selection and final distribution of study cases into the training set and test set. Jan = January, Mar = March.

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Fig 2.

Flow diagram of our proposed CAD algorithms.

TP = true positive, FP = false positive, ANN = artificial neural network.

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Fig 3.

Six spherical templates by sizes (2, 3, and 4 mm) and types (solid and inner-hole).

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Fig 4.

Example of an ANN for FP reduction of BM candidates using computer features.

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Table 1.

Clinical characteristics of the patients.

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Fig 5.

Bar graph of the nodule size distributions in the training and test sets.

The relative frequency of nodules with diameters of 1 to 3 mm differed significantly between the two groups (p = 0.01).

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Fig 6.

Examples of CAD results using algorithm A.

A–D: Examples of the correct detection of BM by CAD software. E–H: Examples of the incorrect detection (FPs) by CAD software. Common sources of FPs included the cortical vessel (F), dural sinus (G), and choroid plexus (H).

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Table 2.

Comparison of the nodule detection performances of algorithm A and algorithm B.

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Table 3.

Comparison of the reviewers’ nodule detection performances.

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Fig 7.

3D gradient-echo contrast-enhanced T1-weighted MR images in an 81-year-old female patient with metastatic lung cancer.

A and B: Axial (A) and coronal (B) images show a tiny enhancing nodule at the left inferior temporal gyrus (arrowhead). This nodule was missed by all four reviewers but was successfully detected by CAD. C: On the navigation MR image for a gamma-knife surgery performed 2 days after (A) and (B), the nodule showed no interval changes. D: On the follow-up MR image taken after 3 months, the nodule disappeared.

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