Our purpose was to develop a computer-aided diagnostic (CAD) scheme for detection of flat lesions (also known as superficial elevated or depressed lesions) in CT colonography (CTC), which utilized 3D massive-training artificial neural networks (MTANNs) for false-positive (FP) reduction. Our CAD scheme consisted of colon segmentation, polyp candidate detection, linear discriminant analysis, and MTANNs. To detect flat lesions, we developed a precise shape analysis in the polyp detection step to accommodate the analysis to include a flat shape. With our MTANN CAD scheme, 68% (19/28) of flat lesions, including six lesions "missed" by radiologists in a multicenter clinical trial, were detected correctly, with 10 (249/25) FPs per patient.

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