The use of AI technology for medical diagnostics has accelerated rapidly in the past decade and AI-powered CAD software products are increasingly being used to analyze medical images, such as chest radiographs or X-rays. In March 2021, the World Health Organization (WHO) recommended for the first time that CAD software programmes may be used in place of human readers for the interpretation of digital CXR in screening and triage for TB disease in individuals aged 15 years or more. Selected ultra-portable digital X-ray systems and CAD software now available in the GDF Catalog at a lower than market pricing.

With the support from the United States Agency for International Development (USAID) and Global Affairs Canada, a practical guide on the implementation of CAD technology and ultraportable X-ray systems was developed to provide advice on how to convert WHO policy guidance into a practical implementation plan, building on initial field experience gained by early implementers.

This guide offers various technical explanations of the newly added products available in the GDF catalog including:

  • Chapter 1 provides an overview of CAD technology, including the place of CAD in diagnostic algorithms, international policy on the use of CAD, the technology behind CAD, an overview of the CAD product landscape, and how to understand the output of CAD - and CAD accuracy.
  • Chapter 2 discusses key implementation considerations when deploying CAD technologies, including the hardware, software, server and internet requirements. This chapter describes the selected CAD products included in Stop TB Partnership’s GDF catalog and pricing information.
  • Chapter 3 introduces ultra-portable X-ray systems available through the GDF procurement mechanism, discussing the core components and accessories, key implementation considerations including portability, electrical power, console and radiation safety. This chapter also discuss all the configurations and pricing of integration of the CAD software with the ultra-portable X-ray systems (with a comparison of all possibility hardware and software combinations).
  • Chapter 4 describes key programmatic steps and considerations for the implementation of CAD and ultra-portable X-ray systems, including situation assessment, stakeholder framework, registration, site preparation and assessment, data privacy and security, installation, training and capacity building as well as monitoring and evaluation. The chapter also introduces several resources (provided below as annexes to this guide) that will help implementers to follow the relevant recommendations.
  • Chapter 5 provides a closer look at threshold score selection strategies for CAD software users and details several alternative strategies for consideration.
  • Chapter 6 highlights the experiences of some early implementers of CAD with ultra-portable X-ray systems.

Relevant implementation resources are available in Annexes, including a high-level checklist of vital implementation steps and budgetary considerations, technical specifications for use during procurement, and checklists for site assessment.

The guide will be periodically updated to reflect product updates, ongoing experience, and to include any relatively straightforward techniques and tools that could be more widely adopted. For further information, please contact zhizhenq@stoptb.org.

Screening and Triage for TB using Computer-Aided Detection (CAD) Technology and Ultra-portable X-Ray Systems: A Practical Guide
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Dépistage et triage de la tuberculose à l'aide de la technologie de détection assistée par ordinateur (DAO) et des systèmes de radiographie ultra-portables : Guide pratique
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Russian translation coming soon. If you would like to translate the guide into your local language, please contact zhizhenq@stoptb.org.