Commercial AI for Lung Nodules: BTS Follow-up Rates Vary Despite Similar Actionable Detection

In a retrospective study of 740 CT/PET-CTs, three commercial AI lung nodule tools detected similar actionable nodules (p=0.73). However, small measurement variations led to significantly more BTS 1-year follow-ups for one tool (p<0.001 vs. another). Fleischner guidelines were mo…

• Retrospective post-market evaluation of 740 routine CT/PET-CT studies using three AI software tools (S1, S2, S3).
• Total nodule detections and false positives differed widely (S1: 1336/965; S2: 1060/720; S3: 1536/1169), suggesting overtreatment risk with standalone AI.
• Hypothetical management analysis; single-center retrospective design limits generalizability to other AI tools or real-world clinical workflow.

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