Beyond Benchmarks: A Framework for Post Deployment Validation of CT Lung Nodule Detection AI

Fuente: arXiv
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Main Author: Soliman, Daniel
Format: Preprint
Published: 2026
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author Soliman, Daniel
author_facet Soliman, Daniel
contents Background: Artificial intelligence (AI) assisted lung nodule detection systems are increasingly deployed in clinical settings without site-specific validation. Performance reported under benchmark conditions may not reflect real-world behavior when acquisition parameters differ from training data. Purpose: To propose and demonstrate a physics-guided framework for evaluating the sensitivity of a deployed lung nodule detection model to systematic variation in CT acquisition parameters. Methods: Twenty-one cases from the publicly available LIDC-IDRI dataset were evaluated using a MONAI RetinaNet model pretrained on LUNA16 (fold 0, no fine-tuning). Five imaging conditions were tested: baseline, 25% dose reduction, 50% dose reduction, 3 mm slice thickness, and 5 mm slice thickness. Dose reduction was simulated via image-domain Gaussian noise; slice thickness via moving average along the z-axis. Detection sensitivity was computed at a confidence threshold of 0.5 with a 15 mm matching criterion. Results: Baseline sensitivity was 45.2% (57/126 consensus nodules). Dose reduction produced slight degradation: 41.3% at 25% dose and 42.1% at 50% dose. The 5 mm slice thickness condition produced a marked drop to 26.2% - a 19 percentage point reduction representing a 42% relative decrease from baseline. This finding was consistent across confidence thresholds from 0.1 to 0.9. Per-case analysis revealed heterogeneous performance including two cases with complete detection failure at baseline. Conclusion: Slice thickness represents a more fundamental constraint on AI detection performance than image noise under the conditions tested. The proposed framework is reproducible, requires no proprietary scanner data, and is designed to serve as the basis for ongoing post-deployment QA in resource-constrained environment.
format Preprint
id arxiv_https___arxiv_org_abs_2603_26785
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Beyond Benchmarks: A Framework for Post Deployment Validation of CT Lung Nodule Detection AI
Soliman, Daniel
Image and Video Processing
Computer Vision and Pattern Recognition
Medical Physics
Background: Artificial intelligence (AI) assisted lung nodule detection systems are increasingly deployed in clinical settings without site-specific validation. Performance reported under benchmark conditions may not reflect real-world behavior when acquisition parameters differ from training data. Purpose: To propose and demonstrate a physics-guided framework for evaluating the sensitivity of a deployed lung nodule detection model to systematic variation in CT acquisition parameters. Methods: Twenty-one cases from the publicly available LIDC-IDRI dataset were evaluated using a MONAI RetinaNet model pretrained on LUNA16 (fold 0, no fine-tuning). Five imaging conditions were tested: baseline, 25% dose reduction, 50% dose reduction, 3 mm slice thickness, and 5 mm slice thickness. Dose reduction was simulated via image-domain Gaussian noise; slice thickness via moving average along the z-axis. Detection sensitivity was computed at a confidence threshold of 0.5 with a 15 mm matching criterion. Results: Baseline sensitivity was 45.2% (57/126 consensus nodules). Dose reduction produced slight degradation: 41.3% at 25% dose and 42.1% at 50% dose. The 5 mm slice thickness condition produced a marked drop to 26.2% - a 19 percentage point reduction representing a 42% relative decrease from baseline. This finding was consistent across confidence thresholds from 0.1 to 0.9. Per-case analysis revealed heterogeneous performance including two cases with complete detection failure at baseline. Conclusion: Slice thickness represents a more fundamental constraint on AI detection performance than image noise under the conditions tested. The proposed framework is reproducible, requires no proprietary scanner data, and is designed to serve as the basis for ongoing post-deployment QA in resource-constrained environment.
title Beyond Benchmarks: A Framework for Post Deployment Validation of CT Lung Nodule Detection AI
topic Image and Video Processing
Computer Vision and Pattern Recognition
Medical Physics
url https://arxiv.org/abs/2603.26785