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Version 7

Company HQ: 

s-Hertogenbosch, The Netherlands

Download Product Profile

Last Updated:

15th May 2023

CAD4TB is an AI-powered software that is CE-certified by a stringent Dutch regulatory body. Proven to outperform human experts and is endorsed by the WHO.
CAD4TB produces an automated quality assessment of the chest image, a heat map indicating possible areas of abnormalities, and a score (0 - 100) related to the likelihood of a CXR image showing abnormalities associated with TB. Recent updates include CAD modules automatically detecting possible early signs of heart failure (Cardiomegaly) and Silicosis.
CAD4TB works online (CAD4TBcloud) and offline (CAD4TBbox). CAD4TBbox is relevant for settings with high daily throughput, limited/no internet connectivity or for programs with budget constraints for data exchange. Data synchronization is possible from CAD4TBbox to CAD4TBcloud.
CAD4TB Platform enables advanced data management and monitoring, offering modules for registration, customizable symptom screening, CAD4TB results, and confirmatory test results. It also produces individual reporting and program ‘insights’, showing statistical representations of the data.
Delft can advise optimal CAD4TB score threshold setting at free-of-charge.


CE Class IIb. CE 0344 marked

Development Stage

On the Market


Online & Offline

Intended Age Group

4+ years

Target Setting

Outreach and mobile health services, primary healthcare facilities, general hospitals (above primary level), occupational health programmes, teleradiology companies, government/public sector, e.g. national TB programme, private sector

Current Market

CAD4TB is in use in over 60 countries worldwide and is supported by multiple languages including English, French, Portuguese, Russian and Spanish. A complete list can be found on the website:


Can be used to read images from any kind of digital X-ray machine.
Chest X-ray image format: DICOM, PNG, JPEG.
By using an app (SNAP4CAD), analogue X-ray images can be used as well.
Chest X-ray type: PA (Posterior-Anterior) CXR from stationary, portable, and ultra-portable X-ray systems.


The CAD4TB results consist of:

Abnormality score for TB

Binary classification “Possible TB” or “No TB”

Heat map

Cardiothoracic ratio

With the CAD4TB platform, a full report with screening results as well as advanced management dashboard to monitor screening progress are available.


CAD4TB comes as a complete product and is installed on a mini computer called the CAD4TBbox.


All leading cloud computing providers are supported. In country or on-premise servers are available upon request.



CAD4TB comes as a complete product and is installed on a mini computer called the CAD4TBbox.

Integration with X-ray Systems

Integration with PACS and Legacy Systems

We use the DICOM standard to integrate X-ray systems with CAD4TB software. The X-ray system sends a DICOM image to the CAD4TB server (CAD4TBbox or CAD4TBcloud). Over the past decade, multiple X-ray systems from all major manufacturers including CANON, AGFA, Philips, Fujifilm, and GE etc. have been connected to CAD4TB.

CAD4TB uses the DICOM standard or our proprietary API. Using the DICOM standard, it is possible to send the CAD4TB AI results back to a PACS system. This result is a DICOM Secondary Capture image showing the heatmap and scores.


CAD4TB runs on Linux. Currently, Ubuntu LTS 16.04 or newer is preferred.

Processing Time

Less than 5 seconds for the CAD4TBbox. Cloud results processing time depend on internet connectivity.

Data Sharing & Privacy

Server location: All leading cloud computing providers are supported – with multiple data centers around the world. In country or on-premise servers are also available upon request.
No data are shared with the developer. As a company headquartered in the Netherlands, the developer follows the General Data Protection Regulation (GDPR) of the European Union. Each customer receives a Data Processing Agreement that provides clear insight on how their data are processed and used. The developer does not use the data for any other purpose than to provide the CAD4TB result for the customer, unless given explicit permission in writing. Any data processed by CAD4TB remain the property of the customer.
Data are de-identified before they are sent to the server in order to make sure no personal information is sent over the internet, ensuring compliance with privacy regulations.


CAD4TB is available in two ways (perpetual license or per-use-basis):
Perpetual license for CAD4TB software, providing the client with unlimited readings in perpetuity. Clients with a perpetual license that are under warranty or under service contract are eligible to get free-of-charge patches, updates and upgrades.

Pre-negotiated prices for CAD4TB software, CAD4TBbox, Training and Support & Maintenance Contracts are available through selected partners and pooled procurement mechanisms including PFSCM/ and the StopTB Partnership’s Global Drug Facility. Please see the GDF Diagnostics Catalogue for more details.
When Delft Light (ultra-portable X-ray in backpack of Delft Imaging) and CAD4TB software are purchased together, CAD4TBbox is provided free of charge.

In parallel, CAD4TB is available on a per use basis. Bundle prices depend on volume and typically range from US $ 0.45 to US $ 0.95 depending on the order quantity (Higher volume cheaper price).
Offline: Upfront cost for a CAD4TBbox is US$ 5,000 (for 1 CAD4TBbox, prices decrease based on quantity) and is inclusive of shipment, remote support and 12-year warranty on the hardware.
Online: Upfront cost for cloud service (for primary or secondary review and/or archiving purposes) is US$2,500 and entails the setup of the cloud server, the installation of the upload program which allows images to be sent compressed and de-identified if required and remote support.

There is no pricing difference for public or private sector. Prices can be further customized on a project basis depending on project objectives and goals.

Software Updates

Annual software updates
Updates are included in the price. Software upgrades can be facilitated through support and maintenance contracts

Product Development Method

Supervised deep learning (CNN, RNN) plus manual feature engineering


The product was trained on 1 million chest X-rays from several countries and continents

Reference Standard

Human reader, culture and GeneXpert MTB/RIF results


Over 65 scientific publications and references. A complete list of all publications related to CAD4TB can be found on

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