{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:02:00Z","timestamp":1792058520359,"version":"4.4.0"},"reference-count":10,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Inst. Med. trop. S. Paulo"],"abstract":"<jats:p>ABSTRACT Pediatric tuberculosis (TB) remains a diagnostic challenge in Brazil and worldwide. The Brazilian Ministry of Health recommends a clinical scoring system (S-MoH) for children and adolescents with suspected TB. Interpretation of radiographs within this scoring system may require specialist input. AI-based systems, such as CAD4TB (Delft Imaging Systems B.V.), approved by the WHO for adults, are not yet recommended for standalone use in children under 15 years of age. A retrospective study was conducted at a pediatric institute from January 31, 2017, to January 29, 2025, including 179 patients aged 0\u201314 years with pulmonary TB or other diseases. CAD4TBv7.1 analyzed chest radiographs using two cutoff points established by Youden's index: 53.48 for analyses against the S-MoH score and 53.89 for analyses against microbiological confirmation. Results were compared with both microbiological confirmation and S-MoH score. Among the 179 participants, 61 (34.1%) had TB, 25 of which were microbiologically confirmed. CAD4TBv7.1 showed an area under the ROC curve (AUROC) of 0.71, with a sensitivity of 52% and a specificity of 86.3% compared with microbiological diagnosis. Against S-MoH, AUROC was 0.59, with a sensitivity of 34.43% and a specificity of 86.44%. CAD4TBv7.1 demonstrated low sensitivity and high specificity, particularly regarding its overall discriminative capacity. Thus, CAD4TBv7.1 emerges as a promising complementary screening tool for pediatric TB. Although its standalone use is not yet recommended, it may complement S-MoH in settings lacking radiologists. Investments in AI must be accompanied by consistent pediatric validation and strategies that combine technological innovation with traditional and cost-effective clinical approach.<\/jats:p>","DOI":"10.1590\/s1678-9946202668005","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T15:04:12Z","timestamp":1769785452000},"source":"Crossref","is-referenced-by-count":3,"title":["Contribution of artificial intelligence to the imaging diagnosis of pediatric pulmonary tuberculosis"],"prefix":"10.1590","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5322-410X","authenticated-orcid":false,"given":"Roberta Feij\u00f3","family":"Carvalho","sequence":"first","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4238-3746","authenticated-orcid":false,"given":"Sandra Val\u00e9ria Coelho da","family":"Silva","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4780-9280","authenticated-orcid":false,"given":"Michely Alexandrino de Souza","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2727-520X","authenticated-orcid":false,"given":"Rafaela Baroni","family":"Aurilio","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5793-2244","authenticated-orcid":false,"given":"Edwin Tao Ming","family":"Klinkenberg","sequence":"additional","affiliation":[{"name":"Delft Imaging Systems B.V.,  Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9221-3952","authenticated-orcid":false,"given":"Sara Vegas","family":"Viedma","sequence":"additional","affiliation":[{"name":"Delft Imaging Systems B.V.,  Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3633-6070","authenticated-orcid":false,"given":"Maria de F\u00e1tima Bazhuni Pombo","family":"Sant\u2019Anna","sequence":"additional","affiliation":[{"name":"Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1349-7311","authenticated-orcid":false,"given":"Ana Alice Amaral Ibiapina","family":"Parente","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7638-6814","authenticated-orcid":false,"given":"Claudete Aparecida Ara\u00fajo","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8732-8065","authenticated-orcid":false,"given":"Clemax Couto","family":"Sant\u2019Anna","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"N Esp","key":"ref1","first-page":"1","article-title":"Minist\u00e9rio da Sa\u00fade. Secretaria de Vigil\u00e2ncia em Sa\u00fade e Ambiente. Tuberculose 2025","year":"2025","journal-title":"Bol Epidemiol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"805","DOI":"10.5588\/ijtld.18.0004","article-title":"Automated chest X-ray reading for tuberculosis in the Philippines to improve case detection: a cohort study","volume":"23","author":"Philipsen RH","year":"2019","journal-title":"Int J Tuberc Lung Dis"},{"key":"ref3","series-title":"atual","volume-title":"Minist\u00e9rio da Sa\u00fade. Secretaria de Vigil\u00e2ncia em Sa\u00fade. Departamento de Vigil\u00e2ncia das Doen\u00e7as Transmiss\u00edveis. Manual de recomenda\u00e7\u00f5es para o controle da tuberculose no Brasil. 2\u00aa ed","year":"2019"},{"key":"ref4","article-title":"Diagnosis and management of tuberculosis in children","volume":"51","author":"Fernandes MF","year":"2025","journal-title":"J Bras Pneumol"},{"key":"ref5","series-title":"Guia de vigil\u00e2ncia em sa\u00fade","volume-title":"Minist\u00e9rio da Sa\u00fade. Secretaria de Vigil\u00e2ncia em Sa\u00fade e Ambiente. Departamento de Articula\u00e7\u00e3o Estrat\u00e9gica de Vigil\u00e2ncia em Sa\u00fade e Ambiente","year":"2023","edition":"6. ed."},{"key":"ref6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0001799","article-title":"Optimising computer-aided detection to identify intra-thoracic tuberculosis on chest X-ray in South African children","volume":"3","author":"Palmer M","year":"2023","journal-title":"PLOS Glob Public Health"},{"key":"ref7","series-title":"Use of computer-aided detection software for tuberculosis screening: WHO policy statement","year":"2025"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"2400811","DOI":"10.1183\/13993003.00811-2024","article-title":"Accuracy of CAD4TB (Computer-Aided Detection for Tuberculosis) on paediatric chest radiographs","volume":"64","author":"Edem VF","year":"2024","journal-title":"Eur Respir J"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"S179","DOI":"10.1093\/cid\/civ581","article-title":"Clinical case definitions for classification of intrathoracic tuberculosis in children: an update","volume":"61","author":"Graham SM","year":"2015","journal-title":"Clin Infect Dis"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1002\/bimj.200710415","article-title":"Youden index and optimal cut-point estimated from observations affected by a lower limit of detection","volume":"50","author":"Ruopp MD","year":"2008","journal-title":"Biom J"}],"container-title":["Revista do Instituto de Medicina Tropical de S\u00e3o Paulo"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0036-46652026000101402&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T15:04:14Z","timestamp":1769785454000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0036-46652026000101402&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":10,"alternative-id":["S0036-46652026000101402"],"URL":"https:\/\/doi.org\/10.1590\/s1678-9946202668005","relation":{},"ISSN":["1678-9946"],"issn-type":[{"value":"1678-9946","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e5"}}