Telemedicine allowed greater access to the healthcare system, reduced the need to employ emergency services, improved assessment/control of symptoms, and provided greater orientation and confidence in the care given by family members through early and proactive interventions. Web conferencing proved to be a good adjuvant to home monitoring of symptoms, complementing in-person assistance.

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Lung cancer is a disease with significant prevalence in several countries around the world. Its difficult treatment and rapid progression make the mortality rates among people affected by this illness to be very high. Aiming to offer a computational alternative for helping in detection of nodules, serving as a second opinion to the specialists, this work proposes a totally automatic methodology based on successive detection refining stages. The automated lung nodules detection scheme consists of six stages: thorax extraction, lung extraction, lung reconstruction, structures extraction, tubular structures elimination, and false positive reduction. In the thorax extraction stage all the artifacts external to the patient's body are discarded. Lung extraction stage is responsible for the identification of the lung parenchyma. The objective of the lung reconstruction stage is to prevent incorrect elimination of portions belonging to the parenchyma. Structures extraction stage comprises the selection of dense structures from inside the lung parenchyma. The next stage, tubular structures elimination eliminates a great part of the pulmonary trees. Finally, the false positive stage selects only structures with great probability to be nodule. Each of the several stages has very specific objectives in detection of particular cases of lung nodules, ensuring good matching rates even in difficult detection situations. We use 33 exams with diversified diagnosis and slices numbers for validating the methodology. We obtained a false positive per exam rate of 0.42 and false negative rate of 0.15. The total classification sensitivity obtained, measured out of the nodule candidates, was 84.84%. The specificity achieved was 96.15% and the total accuracy of the method was 95.21%.

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