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Qi L, Li X, Yang Y, Zhao M, Lin A, Ma L. Accuracy of machine learning in the preoperative identification of ovarian borderline tumors: a meta-analysis. Clin Radiol 2024; 79:501-514. [PMID: 38670918 DOI: 10.1016/j.crad.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/07/2024] [Accepted: 02/22/2024] [Indexed: 04/28/2024]
Abstract
AIM The objective of this study is to explore the diagnostic value of machine learning (ML) in borderline ovarian tumors through meta-analysis. METHODS Pubmed, Embase, Web of Science, and Cochrane Library databases were comprehensively retrieved from database inception untill February 16, 2023. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was adopted to evaluate the risk of bias in the original studies. Sub-group analyses of ML were conducted according to clinical features and radiomics features. We separately discussed the discriminative value of ML for borderline vs benign and borderline vs malignant tumors. RESULTS Eighteen studies involving 12,778 subjects were included in our analysis. The modeling variables mainly consisted of radiomics features (n=13) and a small number of clinical features (n=5). When distinguishing between borderline and benign tumors, the ML model based on radiomic features achieved a c-index of 0.782 (95% CI: 0.732-0.831), sensitivity of 0.75 (95% CI: 0.67-0.82), and specificity of 0.75 (95% CI: 0.67-0.81) in the validation set. When distinguishing between borderline and malignant tumors, the ML model based on radiomic features achieved a c-index of 0.916 (95% CI: 0.891-0.940), sensitivity of 0.86 (95% CI: 0.78-0.91), and specificity of 0.88 (95% CI: 0.82-0.92) in the validation set. In addition, we analyzed the discriminatory ability of radiologists and found that their sensitivity was 0.26 (95% CI: 0.12-0.46) and specificity was 0.94 (95% CI: 0.90-0.97). CONCLUSIONS ML has tremendous potential in the preoperative diagnosis and differentiation of borderline ovarian tumors and may be more accurate than radiologists in diagnosing and differentiating borderline ovarian tumors.
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Affiliation(s)
- L Qi
- Department of Gynecology and Obstetrics, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai City, Shandong Province, China
| | - X Li
- Department of Pathology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai City, Shandong Province, China
| | - Y Yang
- Emergency Department, HongQi Hospital Affiliated to MuDanJiang Medical University, MuDanJiang City, Heilongjiang Province, China
| | - M Zhao
- Department of Gynecology and Obstetrics, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai City, Shandong Province, China
| | - A Lin
- Department of Gynecology and Obstetrics, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai City, Shandong Province, China.
| | - L Ma
- Center for Laboratory Diagnosis, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai City, Shandong Province, China.
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Xu H, Zhu N, Yue Y, Guo Y, Wen Q, Gao L, Hou Y, Shang J. Spectral CT-based radiomics signature for distinguishing malignant pulmonary nodules from benign. BMC Cancer 2023; 23:91. [PMID: 36703132 PMCID: PMC9878920 DOI: 10.1186/s12885-023-10572-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 01/20/2023] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES To evaluate the discriminatory capability of spectral CT-based radiomics to distinguish benign from malignant solitary pulmonary solid nodules (SPSNs). MATERIALS AND METHODS A retrospective study was performed including 242 patients with SPSNs who underwent contrast-enhanced dual-layer Spectral Detector CT (SDCT) examination within one month before surgery in our hospital, which were randomly divided into training and testing datasets with a ratio of 7:3. Regions of interest (ROIs) based on 40-65 keV images of arterial phase (AP), venous phases (VP), and 120kVp of SDCT were delineated, and radiomics features were extracted. Then the optimal radiomics-based score in identifying SPSNs was calculated and selected for building radiomics-based model. The conventional model was developed based on significant clinical characteristics and spectral quantitative parameters, subsequently, the integrated model combining radiomics-based model and conventional model was established. The performance of three models was evaluated with discrimination, calibration, and clinical application. RESULTS The 65 keV radiomics-based scores of AP and VP had the optimal performance in distinguishing benign from malignant SPSNs (AUC65keV-AP = 0.92, AUC65keV-VP = 0.88). The diagnostic efficiency of radiomics-based model (AUC = 0.96) based on 65 keV images of AP and VP outperformed conventional model (AUC = 0.86) in the identification of SPSNs, and that of integrated model (AUC = 0.97) was slightly further improved. Evaluation of three models showed the potential for generalizability. CONCLUSIONS Among the 40-65 keV radiomics-based scores based on SDCT, 65 keV radiomics-based score had the optimal performance in distinguishing benign from malignant SPSNs. The integrated model combining radiomics-based model based on 65 keV images of AP and VP with Zeff-AP was significantly superior to conventional model in the discrimination of SPSNs.
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Affiliation(s)
- Hang Xu
- grid.412467.20000 0004 1806 3501Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004 China
| | - Na Zhu
- grid.416466.70000 0004 1757 959XDepartment of Radiation Oncology, Nanfang Hospital of Southern Medical University, Guangzhou, 510000 China
| | - Yong Yue
- grid.412467.20000 0004 1806 3501Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004 China
| | - Yan Guo
- GE Healthcare, Shenyang, 110004 China
| | - Qingyun Wen
- grid.459518.40000 0004 1758 3257Department of Radiology, Jining First People’s Hospital, Jining, 272000 China
| | - Lu Gao
- Department of Radiology, Liaoning Province Cancer Hospital, Shenyang, 110801 China
| | - Yang Hou
- grid.412467.20000 0004 1806 3501Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004 China
| | - Jin Shang
- grid.412467.20000 0004 1806 3501Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004 China
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Ge G, Zhang J. Feature selection methods and predictive models in CT lung cancer radiomics. J Appl Clin Med Phys 2023; 24:e13869. [PMID: 36527376 PMCID: PMC9860004 DOI: 10.1002/acm2.13869] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/31/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Radiomics is a technique that extracts quantitative features from medical images using data-characterization algorithms. Radiomic features can be used to identify tissue characteristics and radiologic phenotyping that is not observable by clinicians. A typical workflow for a radiomics study includes cohort selection, radiomic feature extraction, feature and predictive model selection, and model training and validation. While there has been increasing attention given to radiomic feature extraction, standardization, and reproducibility, currently, there is a lack of rigorous evaluation of feature selection methods and predictive models. Herein, we review the published radiomics investigations in CT lung cancer and provide an overview of the commonly used radiomic feature selection methods and predictive models. We also compare limitations of various methods in clinical applications and present sources of uncertainty associated with those methods. This review is expected to help raise awareness of the impact of radiomic feature and model selection methods on the integrity of radiomics studies.
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Affiliation(s)
- Gary Ge
- Department of Radiology, University of Kentucky, Lexington, Kentucky, USA
| | - Jie Zhang
- Department of Radiology, University of Kentucky, Lexington, Kentucky, USA
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Incremental benefits of size-zone matrix-based radiomics features for the prognosis of lung adenocarcinoma: advantage of spatial partitioning on tumor evaluation. Eur Radiol 2022; 32:7691-7699. [PMID: 35554645 DOI: 10.1007/s00330-022-08818-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/04/2022] [Accepted: 04/13/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Prognostic models of lung adenocarcinoma (ADC) can be built using radiomics features from various categories. The size-zone matrix (SZM) features have a strong biological basis related to tumor partitioning, but their incremental benefits have not been fully explored. In our study, we aimed to evaluate the incremental benefits of SZM features for the prognosis of lung ADC. METHODS A total of 298 patients were included and their pretreatment computed tomography images were analyzed in fivefold cross-validation. We built a risk model of overall survival using SZM features and compared it with a conventional radiomics risk model and a clinical variable-based risk model. We also compared it with other models incorporating various combinations of SZM features, other radiomics features, and clinical variables. A total of seven risk models were compared and evaluated using the hazard ratio (HR) on the left-out test fold. RESULTS As a baseline, the clinical variable risk model showed an HR of 2.739. Combining the radiomics signature with SZM feature was better (HR 4.034) than using radiomics signature alone (HR 3.439). Combining radiomics signature, SZM feature, and clinical variable (HR 6.524) fared better than just combining radiomics signature and clinical variables (HR 4.202). These results confirmed the added benefits of SZM features for prognosis in lung ADC. CONCLUSION Combining SZM feature with the radiomics signature was better than using the radiomics signature alone and the benefits of SZM features were maintained when clinical variables were added confirming the incremental benefits of SZM features for lung ADC prognosis. KEY POINTS • Size-zone matrix (SZM) features provide incremental benefits for the prognosis of lung adenocarcinoma. • Combining the radiomics signature with SZM features performed better than using a radiomics signature alone.
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Cui R, Yang Z, Liu L. What does radiomics do in PD-L1 blockade therapy of NSCLC patients? Thorac Cancer 2022; 13:2669-2680. [PMID: 36039482 PMCID: PMC9527165 DOI: 10.1111/1759-7714.14620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 12/19/2022] Open
Abstract
With the in‐depth understanding of programmed cell death 1 ligand 1 (PD‐L1) in non‐small cell lung cancer (NSCLC), PD‐L1 has become a vital immunotherapy target and a significant biomarker. The clinical utility of detecting PD‐L1 by immunohistochemistry or next‐generation sequencing has been written into guidelines. However, the application of these methods is limited in some circumstances where the biopsy size is small or not accessible, or a dynamic monitor is needed. Radiomics can noninvasively, in real‐time, and quantitatively analyze medical images to reflect deeper information about diseases. Since radiomics was proposed in 2012, it has been widely used in disease diagnosis and differential diagnosis, tumor staging and grading, gene and protein phenotype prediction, treatment plan decision‐making, efficacy evaluation, and prognosis prediction. To explore the feasibility of the clinical application of radiomics in predicting PD‐L1 expression, immunotherapy response, and long‐term prognosis, we comprehensively reviewed and summarized recently published works in NSCLC. In conclusion, radiomics is expected to be a companion to the whole immunotherapy process.
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Affiliation(s)
- Ruichen Cui
- Institute of Thoracic Oncology and Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhenyu Yang
- Institute of Thoracic Oncology and Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Lunxu Liu
- Institute of Thoracic Oncology and Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
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Combined clinical and specific positron emission tomography/computed tomography-based radiomic features and machine-learning model in prediction of thymoma risk groups. Nucl Med Commun 2022; 43:529-539. [PMID: 35234213 DOI: 10.1097/mnm.0000000000001547] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES In this single-center study, we aimed to propose a machine-learning model and assess its ability with clinical data to classify low- and high-risk thymoma on fluorine-18 (18F) fluorodeoxyglucose (FDG) (18F-FDG) PET/computed tomography (CT) images. METHODS Twenty-seven patients (14 male, 13 female; mean age: 49.6 ± 10.2 years) who underwent PET/CT to evaluate the suspected anterior mediastinal mass and histopathologically diagnosed with thymoma were included. On 18F-FDG PET/CT images, the anterior mediastinal tumor was segmented. Standardized uptake value (SUV)max, SUVmean, SUVpeak, MTV and total lesion glycolysis of primary mediastinal lesions were calculated. For texture analysis first, second, and higher-order texture features were calculated. Clinical information includes gender, age, myasthenia gravis status; serum levels of lactate dehydrogenase (LDH), alkaline phosphatase, C-reactive protein, hemoglobin, white blood cell, lymphocyte and platelet counts were included in the analysis. RESULTS Histopathologic examination was consistent with low risk and high-risk thymoma in 15 cases and 12 cases, respectively. The age and myasthenic syndrome were statistically significant in both groups (P = 0.039 and P = 0.05, respectively). The serum LDH level was also statistically significant in both groups (450.86 ± 487.07 vs. 204.82 ± 59.04; P < 0.001). The highest AUC has been achieved with MLP Classifier (ANN) machine learning method, with a range of 0.830 then the other learning classifiers. Three features were identified to differentiate low- and high-risk thymoma for the machine learning, namely; myasthenia gravis, LDH, SHAPE_Sphericity [only for 3D ROI (nz>1)]. CONCLUSIONS This small dataset study has proposed a machine-learning model by MLP Classifier (ANN) analysis on 18F-FDG PET/CT images, which can predict low risk and high-risk thymoma. This study also demonstrated that the combination of clinical data and specific PET/CT-based radiomic features with image variables can predict thymoma risk groups. However, these results should be supported by studies with larger dataset.
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Balagurunathan Y, Beers A, McNitt-Gray M, Hadjiiski L, Napel S, Goldgof D, Perez G, Arbelaez P, Mehrtash A, Kapur T, Yang E, Moon JW, Bernardino G, Delgado-Gonzalo R, Farhangi MM, Amini AA, Ni R, Feng X, Bagari A, Vaidhya K, Veasey B, Safta W, Frigui H, Enguehard J, Gholipour A, Castillo LS, Daza LA, Pinsky P, Kalpathy-Cramer J, Farahani K. Lung Nodule Malignancy Prediction in Sequential CT Scans: Summary of ISBI 2018 Challenge. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:3748-3761. [PMID: 34264825 PMCID: PMC9531053 DOI: 10.1109/tmi.2021.3097665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Lung cancer is by far the leading cause of cancer death in the US. Recent studies have demonstrated the effectiveness of screening using low dose CT (LDCT) in reducing lung cancer related mortality. While lung nodules are detected with a high rate of sensitivity, this exam has a low specificity rate and it is still difficult to separate benign and malignant lesions. The ISBI 2018 Lung Nodule Malignancy Prediction Challenge, developed by a team from the Quantitative Imaging Network of the National Cancer Institute, was focused on the prediction of lung nodule malignancy from two sequential LDCT screening exams using automated (non-manual) algorithms. We curated a cohort of 100 subjects who participated in the National Lung Screening Trial and had established pathological diagnoses. Data from 30 subjects were randomly selected for training and the remaining was used for testing. Participants were evaluated based on the area under the receiver operating characteristic curve (AUC) of nodule-wise malignancy scores generated by their algorithms on the test set. The challenge had 17 participants, with 11 teams submitting reports with method description, mandated by the challenge rules. Participants used quantitative methods, resulting in a reporting test AUC ranging from 0.698 to 0.913. The top five contestants used deep learning approaches, reporting an AUC between 0.87 - 0.91. The team's predictor did not achieve significant differences from each other nor from a volume change estimate (p =.05 with Bonferroni-Holm's correction).
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Affiliation(s)
| | | | | | | | - Sandy Napel
- Dept. of Radiology, School of Medicine, Stanford University (SU), CA
| | | | - Gustavo Perez
- Biomedical computer vision lab (BCV), Universidad de los Andes, Colombia
| | - Pablo Arbelaez
- Biomedical computer vision lab (BCV), Universidad de los Andes, Colombia
| | - Alireza Mehrtash
- Robotics and Control Laboratory (RCL), Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC
- Surgical Planning Laboratory (SPL), Radiology Department, Brigham and Women’s Hospital, Boston, MA, 02130
| | - Tina Kapur
- Surgical Planning Laboratory (SPL), Radiology Department, Brigham and Women’s Hospital, Boston, MA, 02130
| | - Ehwa Yang
- Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Jung Won Moon
- Human Medical Imaging & Intervention Center, Seoul 06524, Korea
| | - Gabriel Bernardino
- Centre Suisse d’Électronique et de Microtechnique, Neuchâtel, Switzerland
| | | | - M. Mehdi Farhangi
- Medical Imaging Laboratory, University of Louisville, Louisville, KY. USA
- Computer Engineering and Computer Science, University of Louisville
| | - Amir A. Amini
- Medical Imaging Laboratory, University of Louisville, Louisville, KY. USA
- Electrical and Computer Engineering Department, University of Louisville, Louisville, KY. USA
| | | | - Xue Feng
- Spingbok Inc
- Department of Biomedical Engineering, University of Virginia, Charlottesville
| | | | | | - Benjamin Veasey
- Medical Imaging Laboratory, University of Louisville, Louisville, KY. USA
- Electrical and Computer Engineering Department, University of Louisville, Louisville, KY. USA
| | - Wiem Safta
- Computer Engineering and Computer Science, University of Louisville
| | - Hichem Frigui
- Computer Engineering and Computer Science, University of Louisville
| | - Joseph Enguehard
- Department of Radiology, Boston Children’s Hospital, and Harvard Medical School
| | - Ali Gholipour
- Department of Radiology, Boston Children’s Hospital, and Harvard Medical School
| | | | - Laura Alexandra Daza
- Department of Biomedical Engineering, Universidad de los Andes, Bogota, Colombia
| | - Paul Pinsky
- Divsion of Cancer Prevention, National Cancer Institute (NCI), Washington DC
| | | | - Keyvan Farahani
- Center for Biomedical Informatics and Information Technology, National Cancer Institute (NCI), Washington DC
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One deep learning local-global model based on CT imaging to differentiate between nodular cryptococcosis and lung cancer which are hard to be diagnosed. Comput Med Imaging Graph 2021; 94:102009. [PMID: 34741847 DOI: 10.1016/j.compmedimag.2021.102009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 10/05/2021] [Accepted: 10/14/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES We aim to evaluate a deep learning (DL) model and radiomic model for preoperative differentiation of nodular cryptococcosis from solitary lung cancer in patients with malignant features on CT images. MATERIALS AND METHODS We retrospectively recruited 319 patients with solitary pulmonary nodules and suspicious signs of malignancy from three hospitals. All lung nodules were resected, and one by one radiologic-pathologic correlation was performed. A three-dimensional DL model was used for tumor segmentation and extraction of three-dimensional radiomic features. We used the Max-Relevance and Min-Redundancy algorithm and the eXtreme Gradient Boosting algorithm to select the nodular radiomics features. We proposed a DL local-global model, a DL local model and radiomic model to preoperatively differentiate nodular cryptococcosis from solitary lung cancer. The DL local-global model includes information of both nodules and the whole lung, while the DL local model only includes information of solitary lung nodules. Five-fold cross-validation was used to select and validate these models. The prediction performance of the model was evaluated using receiver operating characteristic curve (ROC) and calibration curve. A new loss function was applied in our deep learning framework to optimize the area under the ROC curve (AUC) directly. RESULTS 295 patients were enrolled and they were non-symptomatic, with negative tumor markers and fungus markers in blood tests. These patients have not been diagnosed by the combination of CT imaging, laboratory results and clinical data. The lung volume was slightly larger in patients with lung cancers than that in patients with cryptococcosis (3552.8 ± 1184.6 ml vs 3491.9 ± 1017.8 ml). The DL local-global model achieved the best performance in differentiating between nodular cryptococcosis and lung cancer (area under the curve [AUC] = 0.88), which was higher than that of the DL local model (AUC = 0.84) and radiomic (AUC = 0.79) model. CONCLUSION The DL local-global model is a non-invasive diagnostic tool to differentiate between nodular cryptococcosis and lung cancer nodules which are hard to be diagnosed by the combination of CT imaging, laboratory results and clinical data, and overtreatment may be avoided.
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Tunali I, Gillies RJ, Schabath MB. Application of Radiomics and Artificial Intelligence for Lung Cancer Precision Medicine. Cold Spring Harb Perspect Med 2021; 11:cshperspect.a039537. [PMID: 33431509 PMCID: PMC8288444 DOI: 10.1101/cshperspect.a039537] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Medical imaging is the standard-of-care for early detection, diagnosis, treatment planning, monitoring, and image-guided interventions of lung cancer patients. Most medical images are stored digitally in a standardized Digital Imaging and Communications in Medicine format that can be readily accessed and used for qualitative and quantitative analysis. Over the several last decades, medical images have been shown to contain complementary and interchangeable data orthogonal to other sources such as pathology, hematology, genomics, and/or proteomics. As such, "radiomics" has emerged as a field of research that involves the process of converting standard-of-care images into quantitative image-based data that can be merged with other data sources and subsequently analyzed using conventional biostatistics or artificial intelligence (AI) methods. As radiomic features capture biological and pathophysiological information, these quantitative radiomic features have shown to provide rapid and accurate noninvasive biomarkers for lung cancer risk prediction, diagnostics, prognosis, treatment response monitoring, and tumor biology. In this review, radiomics and emerging AI methods in lung cancer research are highlighted and discussed including advantages, challenges, and pitfalls.
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Affiliation(s)
- Ilke Tunali
- Department of Cancer Physiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA
| | - Robert J Gillies
- Department of Cancer Physiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA
| | - Matthew B Schabath
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA
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Bertholet J, Vinogradskiy Y, Hu Y, Carlson DJ. Advances in Image-Guided Adaptive Radiation Therapy. Int J Radiat Oncol Biol Phys 2021; 110:625-628. [PMID: 34089669 DOI: 10.1016/j.ijrobp.2021.02.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jenny Bertholet
- Division of Medical Radiation Physics, Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yevgeniy Vinogradskiy
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado
| | - Yanle Hu
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona
| | - David J Carlson
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
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A Novel Nodule Edge Sharpness Radiomic Biomarker Improves Performance of Lung-RADS for Distinguishing Adenocarcinomas from Granulomas on Non-Contrast CT Scans. Cancers (Basel) 2021; 13:cancers13112781. [PMID: 34205005 PMCID: PMC8199879 DOI: 10.3390/cancers13112781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/31/2021] [Indexed: 11/18/2022] Open
Abstract
Simple Summary The great majority of pulmonary nodules on screening CT scans are benign (95%). Due to inaccurate diagnoses of granulomas from adenocarcinomas on CT scans, many patients with benign nodules are subjected to unnecessary surgical procedures. The aim of this retrospective study is to evaluate the discriminability of a new radiomic feature, nodule edge/interface sharpness (NIS), for distinguishing lung adenocarcinomas from benign granulomas on non-contrast CT scans. Moreover, we aim to evaluate whether NIS can improve the performance of Lung-RADS, by reclassifying benign nodules that were initially assessed as suspicious. In a cohort of 352 patients with diagnostic non-contrast CT scans, NIS radiomics was able to classify nodules with an area under the receiver operating characteristic curve (ROC AUC) of 0.77, and when combined with intra-tumoral textural and shape features, classification performance increased to AUC of 0.84. Additionally, the NIS classifier correctly reclassified 46% of those lesions that were actually benign but deemed suspicious by Lung-RADS. Combining NIS with Lung-RADS has the potential to alter patient management by significantly decreasing unnecessary biopsies/follow up imaging. Abstract The aim of this study is to evaluate whether NIS radiomics can distinguish lung adenocarcinomas from granulomas on non-contrast CT scans, and also to improve the performance of Lung-RADS by reclassifying benign nodules that were initially assessed as suspicious. The screening or standard diagnostic non-contrast CT scans of 362 patients was divided into training (St, N = 145), validation (Sv, N = 145), and independent validation (Siv, N = 62) sets from different institutions. Nodules were identified and manually segmented on CT images by a radiologist. A series of 264 features relating to the edge sharpness transition from the inside to the outside of the nodule were extracted. The top 10 features were used to train a linear discriminant analysis (LDA) machine learning classifier on St. In conjunction with the LDA classifier, NIS radiomics classified nodules with an AUC of 0.82 ± 0.04, 0.77, and 0.71 respectively on St, Sv, and Siv. We evaluated the ability of the NIS classifier to determine the proportion of the patients in Sv that were identified initially as suspicious by Lung-RADS but were reclassified as benign by applying the NIS scores. The NIS classifier was able to correctly reclassify 46% of those lesions that were actually benign but deemed suspicious by Lung-RADS alone on Sv.
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Khorrami M, Bera K, Thawani R, Rajiah P, Gupta A, Fu P, Linden P, Pennell N, Jacono F, Gilkeson RC, Velcheti V, Madabhushi A. Distinguishing granulomas from adenocarcinomas by integrating stable and discriminating radiomic features on non-contrast computed tomography scans. Eur J Cancer 2021; 148:146-158. [PMID: 33743483 DOI: 10.1016/j.ejca.2021.02.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To identify stable and discriminating radiomic features on non-contrast CT scans to develop more generalisable radiomic classifiers for distinguishing granulomas from adenocarcinomas. METHODS In total, 412 patients with adenocarcinomas and granulomas from three institutions were retrospectively included. Segmentations of the lung nodules were performed manually by an expert radiologist in a 2D axial view. Radiomic features were extracted from intra- and perinodular regions. A total of 145 patients were used as part of the training set (Str), whereas 205 patients were used as part of test set I (Ste1) and 62 patients were used as part of independent test set II (Ste2). To mitigate the variation of CT acquisition parameters, we defined 'stable' radiomic features as those for which the feature expression remains relatively unchanged between different sites, as assessed using a Wilcoxon rank-sum test. These stable features were used to develop more generalisable radiomic classifiers that were more resilient to variations in lung CT scans. Features were ranked based on two criteria, firstly based on discriminability (i.e. maximising AUC) alone and subsequently based on maximising both feature stability and discriminability. Different machine-learning classifiers (Linear discriminant analysis, Quadratic discriminant analysis, Support vector machines and random forest) were trained with features selected using the two different criteria and then compared on the two independent test sets for distinguishing granulomas from adenocarcinomas, in terms of area under the receiver operating characteristic curve. RESULTS In the test sets, classifiers constructed using the criteria involving maximising feature stability and discriminability simultaneously achieved higher AUC compared with the discriminating alone criteria (Ste1 [n = 205]: maximum AUCs of 0.85versus . 0.80; p-value = 0.047 and Ste2 [n = 62]: maximum AUCs of 0.87 versus. 0.79; p-value = 0.021). These differences held for features extracted from scans with <3 mm slice thickness (AUC = 0.88 versus. 0.80; p-value = 0.039, n = 100) and for the ≥3 mm cases (AUC = 0.81 versus. 0.76; p-value = 0.034, n = 105). In both experiments, shape and peritumoural texture features had a higher stability compared with intratumoural texture features. CONCLUSIONS Our study suggests that explicitly accounting for both stability and discriminability results in more generalisable radiomic classifiers to distinguish adenocarcinomas from granulomas on non-contrast CT scans. Our results also showed that peritumoural texture and shape features were less affected by the scanner parameters compared with intratumoural texture features; however, they were also less discriminating compared with intratumoural features.
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Affiliation(s)
- Mohammadhadi Khorrami
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Kaustav Bera
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Rajat Thawani
- OHSU Knight Cancer Institute, Oregon Health & Science University, Oregon, USA
| | - Prabhakar Rajiah
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Amit Gupta
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Pingfu Fu
- Department of Population and Quantitative Health Sciences, CWRU, Cleveland, OH, USA
| | - Philip Linden
- Thoracic and Esophageal Surgery Department, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Nathan Pennell
- Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH, USA
| | - Frank Jacono
- Pulmonary Section, Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA
| | - Robert C Gilkeson
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | | | - Anant Madabhushi
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA; Louis Stokes Cleveland Veterans Administration Medical Center, Cleveland, OH, USA.
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13
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Tavakoli MB, Orooji M, Teimouri M, Shahabifar R. Distinguishing Adenocarcinomas from Granulomas in the CT scan of the chest: performance degradation evaluation in the automatic segmentation framework. BMC Res Notes 2021; 14:87. [PMID: 33750438 PMCID: PMC7942003 DOI: 10.1186/s13104-021-05502-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 02/25/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The most common histopathologic malignant and benign nodules are Adenocarcinoma and Granuloma, respectively, which have different standards of care. In this paper, we propose an automatic framework for the diagnosis of the Adenocarcinomas and the Granulomas in the CT scans of the chest from a private dataset. We use the radiomic features of the nodules and the attached vessel tortuosity for the diagnosis. The private dataset includes 22 CTs for each nodule type, i.e., adenocarcinoma and granuloma. The dataset contains the CTs of the non-smoker patients who are between 30 and 60 years old. To automatically segment the delineated nodule area and the attached vessels area, we apply a morphological-based approach. For distinguishing the malignancy of the segmented nodule, two texture features of the nodule, the curvature Mean and the number of the attached vessels are extracted. RESULTS We compare our framework with the state-of-the-art feature selection methods for differentiating Adenocarcinomas from Granulomas. These methods employ only the shape features of the nodule, the texture features of the nodule, or the torsion features of the attached vessels along with the radiomic features of the nodule. The accuracy of our framework is improved by considering the four selected features.
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Affiliation(s)
- Mahsa Bank Tavakoli
- Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran
| | - Mahdi Orooji
- Department of Electrical and Computer Engineering, Tarbiat Modares University, Tehran, Iran
| | - Mehdi Teimouri
- Faculty of New Sciences and Technologies, University of Tehran, Tehran, Iran.
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14
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Bartmeyer PM, Biscola NP, Havton LA. A shape-adjusted ellipse approach corrects for varied axonal dispersion angles and myelination in primate nerve roots. Sci Rep 2021; 11:3150. [PMID: 33542368 PMCID: PMC7862494 DOI: 10.1038/s41598-021-82575-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/21/2021] [Indexed: 11/12/2022] Open
Abstract
Segmentation of axons in light and electron micrographs allows for quantitative high-resolution analysis of nervous tissues, but varied axonal dispersion angles result in over-estimates of fiber sizes. To overcome this technical challenge, we developed a novel shape-adjusted ellipse (SAE) determination of axonal size and myelination as an all-inclusive and non-biased tool to correct for oblique nerve fiber presentations. Our new resource was validated by light and electron microscopy against traditional methods of determining nerve fiber size and myelination in rhesus macaques as a model system. We performed detailed segmental mapping and characterized the morphological signatures of autonomic and motor fibers in primate lumbosacral ventral roots (VRs). An en bloc inter-subject variability for the preganglionic parasympathetic fibers within the L7-S2 VRs was determined. The SAE approach allows for morphological ground truth data collection and assignment of individual axons to functional phenotypes with direct implications for fiber mapping and neuromodulation studies.
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Affiliation(s)
- Petra M Bartmeyer
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,School of Electrical and Computer Engineering at University of Campinas, Campinas, SP, Brazil
| | - Natalia P Biscola
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Leif A Havton
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA. .,Departments of Neurology and Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. .,Departments of Neurology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Neurology Service and RR&D National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Administration Medical Center, Bronx, NY, USA.
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15
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Abstract
In the present study, we retrospectively analyzed the records of surgical confirmed kidney cancer with renal cell carcinoma pathology in the database of the hospital. We evaluated the significance of cancer size by assessing the outcomes of proposed adaptive active contour model (ACM). The aim of our study was to develop an adaptive ACM method to measure the radiological size of kidney cancer on computed tomography in the hospital patients. This paper proposed a set of medical image processing, applying images provided by the hospital and select the more obvious cases by the doctors, after the first treatment to remove noise image, and the kidney cancer contour would be circled by using the proposed adaptive ACM method. The results showed that the experimental outcome has highly similarity with the medical professional manual contour. The accuracy rate is higher than 99%. We have developed a novel adaptive ACM approach that well combines a knowledge-based system to contour the kidney cancer size in computed tomography imaging to support the clinical decision.
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Affiliation(s)
- Wei-Yen Hsu
- Department of Information Management
- Advanced Institute of Manufacturing with High-Tech Innovations
- Center for Innovative Research on Aging Society, National Chung Cheng University, Chiayi
| | - Chih-Cheng Lu
- Department of Information Management
- Division of Urology, Department of Surgery, Chi Mei Medical Center, Liouying, Tainan, Taiwan
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16
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Gomes Ataide EJ, Ponugoti N, Illanes A, Schenke S, Kreissl M, Friebe M. Thyroid Nodule Classification for Physician Decision Support Using Machine Learning-Evaluated Geometric and Morphological Features. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6110. [PMID: 33121054 PMCID: PMC7663034 DOI: 10.3390/s20216110] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 10/17/2020] [Accepted: 10/26/2020] [Indexed: 01/18/2023]
Abstract
The classification of thyroid nodules using ultrasound (US) imaging is done using the Thyroid Imaging Reporting and Data System (TIRADS) guidelines that classify nodules based on visual and textural characteristics. These are composition, shape, size, echogenicity, calcifications, margins, and vascularity. This work aims to reduce subjectivity in the current diagnostic process by using geometric and morphological (G-M) features that represent the visual characteristics of thyroid nodules to provide physicians with decision support. A total of 27 G-M features were extracted from images obtained from an open-access US thyroid nodule image database. 11 significant features in accordance with TIRADS were selected from this global feature set. Each feature was labeled (0 = benign and 1 = malignant) and the performance of the selected features was evaluated using machine learning (ML). G-M features together with ML resulted in the classification of thyroid nodules with a high accuracy, sensitivity and specificity. The results obtained here were compared against state-of the-art methods and perform significantly well in comparison. Furthermore, this method can act as a computer aided diagnostic (CAD) system for physicians by providing them with a validation of the TIRADS visual characteristics used for the classification of thyroid nodules in US images.
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Affiliation(s)
- Elmer Jeto Gomes Ataide
- Clinic for Radiology and Nuclear medicine, Department of Nuclear Medicine, Otto-von-Guericke University Medical Faculty, 39120 Magdeburg, Germany; (S.S.); (M.K.)
- INKA-Application Driven Research, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (N.P.); (A.I.); (M.F.)
| | - Nikhila Ponugoti
- INKA-Application Driven Research, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (N.P.); (A.I.); (M.F.)
| | - Alfredo Illanes
- INKA-Application Driven Research, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (N.P.); (A.I.); (M.F.)
| | - Simone Schenke
- Clinic for Radiology and Nuclear medicine, Department of Nuclear Medicine, Otto-von-Guericke University Medical Faculty, 39120 Magdeburg, Germany; (S.S.); (M.K.)
| | - Michael Kreissl
- Clinic for Radiology and Nuclear medicine, Department of Nuclear Medicine, Otto-von-Guericke University Medical Faculty, 39120 Magdeburg, Germany; (S.S.); (M.K.)
| | - Michael Friebe
- INKA-Application Driven Research, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; (N.P.); (A.I.); (M.F.)
- IDTM GmbH, 45657 Recklinghausen, Germany
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17
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Duan C, Chaovalitwongse WA, Bai F, Hippe DS, Wang S, Thammasorn P, Pierce LA, Liu X, You J, Miyaoka RS, Vesselle HJ, Kinahan PE, Rengan R, Zeng J, Bowen SR. Sensitivity analysis of FDG PET tumor voxel cluster radiomics and dosimetry for predicting mid-chemoradiation regional response of locally advanced lung cancer. Phys Med Biol 2020; 65:205007. [PMID: 33027064 PMCID: PMC7593986 DOI: 10.1088/1361-6560/abb0c7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We investigated the sensitivity of regional tumor response prediction to variability in voxel clustering techniques, imaging features, and machine learning algorithms in 25 patients with locally advanced non-small cell lung cancer (LA-NSCLC) enrolled on the FLARE-RT clinical trial. Metabolic tumor volumes (MTV) from pre-chemoradiation (PETpre) and mid-chemoradiation fluorodeoxyglucose-positron emission tomography (FDG PET) images (PETmid) were subdivided into K-means or hierarchical voxel clusters by standardized uptake values (SUV) and 3D-positions. MTV cluster separability was evaluated by CH index, and morphologic changes were captured by Dice similarity and centroid Euclidean distance. PETpre conventional features included SUVmean, MTV/MTV cluster size, and mean radiation dose. PETpre radiomics consisted of 41 intensity histogram and 3D texture features (PET Oncology Radiomics Test Suite) extracted from MTV or MTV clusters. Machine learning models (multiple linear regression, support vector regression, logistic regression, support vector machines) of conventional features or radiomic features were constructed to predict PETmid response. Leave-one-out-cross-validated root-mean-squared-error (RMSE) for continuous response regression (ΔSUVmean) and area-under-receiver-operating-characteristic-curve (AUC) for binary response classification were calculated. K-means MTV 2-clusters (MTVhi, MTVlo) achieved maximum CH index separability (Friedman p < 0.001). Between PETpre and PETmid, MTV cluster pairs overlapped (Dice 0.70-0.87) and migrated 0.6-1.1 cm. PETmid ΔSUVmean response prediction was superior in MTV and MTVlo (RMSE = 0.17-0.21) compared to MTVhi (RMSE = 0.42-0.52, Friedman p < 0.001). PETmid ΔSUVmean response class prediction performance trended higher in MTVlo (AUC = 0.83-0.88) compared to MTVhi (AUC = 0.44-0.58, Friedman p = 0.052). Models were more sensitive to MTV/MTV cluster regions (Friedman p = 0.026) than feature sets/algorithms (Wilcoxon signed-rank p = 0.36). Top-ranked radiomic features included GLZSM-LZHGE (large-zone-high-SUV), GTSDM-CP (cluster-prominence), GTSDM-CS (cluster-shade) and NGTDM-CNT (contrast). Top-ranked features were consistent between MTVhi and MTVlo cluster pairs but varied between MTVhi-MTVlo clusters, reflecting distinct regional radiomic phenotypes. Variability in tumor voxel cluster response prediction can inform robust radiomic target definition for risk-adaptive chemoradiation in patients with LA-NSCLC. FLARE-RT trial: NCT02773238.
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Affiliation(s)
- Chunyan Duan
- Department of Mechanical Engineering, Tongji University School of Mechanical Engineering, Shanghai China
- Department of Industrial Engineering, University of Arkansas College of Engineering, Fayetteville AR
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle WA
| | - W. Art Chaovalitwongse
- Department of Industrial Engineering, University of Arkansas College of Engineering, Fayetteville AR
| | - Fangyun Bai
- Department of Management Science and Engineering, Tongji University School of Economics and Management, Shanghai China
- Department of Industrial, Manufacturing, & Systems Engineering, University of Texas at Arlington College of Engineering, Arlington, TX
| | - Daniel S. Hippe
- Department of Radiology, University of Washington School of Medicine, Seattle WA
| | - Shouyi Wang
- Department of Industrial, Manufacturing, & Systems Engineering, University of Texas at Arlington College of Engineering, Arlington, TX
| | - Phawis Thammasorn
- Department of Industrial Engineering, University of Arkansas College of Engineering, Fayetteville AR
| | - Larry A. Pierce
- Department of Radiology, University of Washington School of Medicine, Seattle WA
| | - Xiao Liu
- Department of Industrial Engineering, University of Arkansas College of Engineering, Fayetteville AR
| | - Jianxin You
- Department of Management Science and Engineering, Tongji University School of Economics and Management, Shanghai China
| | - Robert S. Miyaoka
- Department of Radiology, University of Washington School of Medicine, Seattle WA
| | - Hubert J. Vesselle
- Department of Radiology, University of Washington School of Medicine, Seattle WA
| | - Paul E. Kinahan
- Department of Radiology, University of Washington School of Medicine, Seattle WA
| | - Ramesh Rengan
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle WA
| | - Jing Zeng
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle WA
| | - Stephen R. Bowen
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle WA
- Department of Radiology, University of Washington School of Medicine, Seattle WA
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18
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Lee G, Park H, Bak SH, Lee HY. Radiomics in Lung Cancer from Basic to Advanced: Current Status and Future Directions. Korean J Radiol 2020; 21:159-171. [PMID: 31997591 PMCID: PMC6992443 DOI: 10.3348/kjr.2019.0630] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 10/24/2019] [Indexed: 12/14/2022] Open
Abstract
Ideally, radiomics features and radiomics signatures can be used as imaging biomarkers for diagnosis, staging, prognosis, and prediction of tumor response. Thus, the number of published radiomics studies is increasing exponentially, leading to a myriad of new radiomics-based evidence for lung cancer. Consequently, it is challenging for radiologists to keep up with the development of radiomics features and their clinical applications. In this article, we review the basics to advanced radiomics in lung cancer to guide young researchers who are eager to start exploring radiomics investigations. In addition, we also include technical issues of radiomics, because knowledge of the technical aspects of radiomics supports a well-informed interpretation of the use of radiomics in lung cancer.
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Affiliation(s)
- Geewon Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Radiology and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Hyunjin Park
- School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, Korea.,Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea
| | - So Hyeon Bak
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Radiology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Ho Yun Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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19
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Yoon HJ, Park H, Lee HY, Sohn I, Ahn J, Lee SH. Prediction of tumor doubling time of lung adenocarcinoma using radiomic margin characteristics. Thorac Cancer 2020; 11:2600-2609. [PMID: 32705793 PMCID: PMC7471031 DOI: 10.1111/1759-7714.13580] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 12/13/2022] Open
Abstract
Background Because shape or irregularity along the tumor perimeter can result from interactions between the tumor and the surrounding parenchyma, there could be a difference in tumor growth rate according to tumor margin or shape. However, no attempt has been made to evaluate the correlation between margin or shape features and tumor growth. Methods We evaluated 52 lung adenocarcinoma (ADC) patients who had at least two computed tomographic (CT) examinations before curative resection. Volume‐based doubling times (DTs) were calculated based on CT scans, and patients were divided into two groups according to the growth pattern (GP) of their ADCs (gradually growing tumors [GP I] vs. growing tumors with a temporary decrease in DT [GP II]). CT radiomic features reflecting margin characteristics were extracted, and radiomic features reflective of tumor DT were selected. Results Among the 52 patients, 41 (78.8%) were assigned to GP I and 11 (21.2%) to GP II. Of the 94 radiomic features extracted, eccentricity, surface‐to‐volume ratio, LoG uniformity (σ = 3.5), and LoG skewness (σ = 0.5) were ultimately selected for tumor DT prediction. Selected radiomic features in GP I were surface‐to‐volume ratio, contrast, LoG uniformity (σ = 3.5), and LoG skewness (σ = 0.5), similar to those for total subjects, whereas the radiomic features in GP II were solidity, energy, and busyness. Conclusions This study demonstrated the potential of margin‐related radiomic features to predict tumor DT in lung ADCs. Key points Significant findings of the study We found a relationship between margin‐related radiomic features and tumor doubling time. What this study adds Margin‐related radiomic features can potentially be used as noninvasive biomarkers to predict tumor doubling time in lung adenocarcinoma and inform treatment strategies.
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Affiliation(s)
- Hyun Jung Yoon
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Radiology, Veterans Health Service Medical Center, Seoul, South Korea
| | - Hyunjin Park
- School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, South Korea.,Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, South Korea
| | - Ho Yun Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Insuk Sohn
- Statistics and Data Center, Samsung Medical Center, Seoul, South Korea
| | - Joonghyun Ahn
- Statistics and Data Center, Samsung Medical Center, Seoul, South Korea
| | - Seung-Hak Lee
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, South Korea
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20
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Liu C, Ma C, Duan J, Qiu Q, Guo Y, Zhang Z, Yin Y. Using CT texture analysis to differentiate between peripheral lung cancer and pulmonary inflammatory pseudotumor. BMC Med Imaging 2020; 20:75. [PMID: 32631330 PMCID: PMC7339470 DOI: 10.1186/s12880-020-00475-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 06/26/2020] [Indexed: 12/13/2022] Open
Abstract
Background This study is to distinguish peripheral lung cancer and pulmonary inflammatory pseudotumor using CT-radiomics features extracted from PET/CT images. Methods In this study, the standard 18F-fluorodeoxyglucose positron emission tomography/ computed tomography (18 F-FDG PET/CT) images of 21 patients with pulmonary inflammatory pseudotumor (PIPT) and 21 patients with peripheral lung cancer were retrospectively collected. The dataset was used to extract CT-radiomics features from regions of interest (ROI), The intra-class correlation coefficient (ICC) was used to screen the robust feature from all the radiomic features. Using, then, statistical methods to screen CT-radiomics features, which could distinguish peripheral lung cancer and PIPT. And the ability of radiomics features distinguished peripheral lung cancer and PIPT was estimated by receiver operating characteristic (ROC) curve and compared by the Delong test. Results A total of 435 radiomics features were extracted, of which 361 features showed relatively good repeatability (ICC ≥ 0.6). 20 features showed the ability to distinguish peripheral lung cancer from PIPT. these features were seen in 14 of 330 Gray-Level Co-occurrence Matrix features, 1 of 49 Intensity Histogram features, 5 of 18 Shape features. The area under the curves (AUC) of these features were 0.731 ± 0.075, 0.717, 0.748 ± 0.038, respectively. The P values of statistical differences among ROC were 0.0499 (F9, F20), 0.0472 (F10, F11) and 0.0145 (F11, Mean4). The discrimination ability of forming new features (Parent Features) after averaging the features extracted at different angles and distances was moderate compared to the previous features (Child features). Conclusion Radiomics features extracted from non-contrast CT based on PET/CT images can help distinguish peripheral lung cancer and PIPT.
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Affiliation(s)
- Chenlu Liu
- School of Nuclear Science and Technology, University of South China, Hengyang, 421001, China.,Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Changsheng Ma
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Jinghao Duan
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Qingtao Qiu
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Yanluan Guo
- Department of Medical Imaging, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Zhenhua Zhang
- School of Nuclear Science and Technology, University of South China, Hengyang, 421001, China
| | - Yong Yin
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China.
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21
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Feng B, Chen X, Chen Y, Liu K, Li K, Liu X, Yao N, Li Z, Li R, Zhang C, Ji J, Long W. Radiomics nomogram for preoperative differentiation of lung tuberculoma from adenocarcinoma in solitary pulmonary solid nodule. Eur J Radiol 2020; 128:109022. [PMID: 32371184 DOI: 10.1016/j.ejrad.2020.109022] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/05/2020] [Accepted: 04/13/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To investigate the preoperative differential diagnostic performance of a radiomics nomogram in tuberculous granuloma (TBG) and lung adenocarcinoma (LAC) appearing as solitary pulmonary solid nodules (SPSNs). METHOD We retrospectively recruited 426 patients with SPSNs from two centers and assigned them to training (n = 123), internal validation (n = 121), and external validation cohorts (n = 182). A model of deep learning (DL) was built for tumor segmentation from routine computed tomography (CT) images and extraction of 3D radiomics features. We used the least absolute shrinkage and selection operator (LASSO) logistic regression to build a radiomics signature. A clinical model was developed with clinical factors, including age, gender, and CT-based subjective findings (eg, lesion size, lesion location, lesion margin, lobulated sharp, and spiculation sign). We constructed individualized radiomics nomograms incorporating the radiomics signature and clinical factors to validate the diagnostic ability. RESULTS Three factors - radiomics signature, age, and spiculation sign - were found to be independent predictors and were used to build the radiomics nomogram, which showed better diagnostic accuracy than any single model (all net reclassification improvement p < 0.05). The area under curve yielded was 0.9660 (95% confidence interval [CI], 0.9390-0.9931), 0.9342 (95% CI, 0.8944-0.9739), and 0.9064 (95% CI, 0.8639-0.9490) for the training, internal validation, and external validation cohorts, respectively. Decision curve analysis (DCA) and stratification analysis showed the nomogram has potential for generalizability. CONCLUSION The radiomics nomogram we developed can preoperatively distinguish between LAC and TBG in patient with a SPSN.
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Affiliation(s)
- Bao Feng
- The Department of Radiology, The Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong Province, China; School of Electronic Information and Automation, Guilin University of Aerospace Technology, Guilin, Guangxi Province, China
| | - Xiangmeng Chen
- The Department of Radiology, The Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong Province, China
| | - Yehang Chen
- School of Electronic Information and Automation, Guilin University of Aerospace Technology, Guilin, Guangxi Province, China
| | - Kunfeng Liu
- The Department of Radiology, The Fifth Affiliated Hospital Sun Yat-sen University, Zhuhai, Guangdong Province, China
| | - Kunwei Li
- The Department of Radiology, The Fifth Affiliated Hospital Sun Yat-sen University, Zhuhai, Guangdong Province, China
| | - Xueguo Liu
- The Department of Radiology, The Fifth Affiliated Hospital Sun Yat-sen University, Zhuhai, Guangdong Province, China
| | - Nan Yao
- The Department of Radiology, The Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong Province, China
| | - Zhi Li
- School of Electronic Information and Automation, Guilin University of Aerospace Technology, Guilin, Guangxi Province, China
| | - Ronggang Li
- The Department of Pathology, The Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong Province, China
| | - Chaotong Zhang
- The Department of Radiology, The Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong Province, China
| | - Jianbo Ji
- School of Electronic Information and Automation, Guilin University of Aerospace Technology, Guilin, Guangxi Province, China
| | - Wansheng Long
- The Department of Radiology, The Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong Province, China.
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22
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Wei SC, Xu L, Li WH, Li Y, Guo SF, Sun XR, Li WW. Risk stratification in GIST: shape quantification with CT is a predictive factor. Eur Radiol 2020; 30:1856-1865. [PMID: 31900704 PMCID: PMC7062662 DOI: 10.1007/s00330-019-06561-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/19/2019] [Accepted: 10/30/2019] [Indexed: 12/13/2022]
Abstract
Background Tumor shape is strongly associated with some tumor’s genomic subtypes and patient outcomes. Our purpose is to find the relationship between risk stratification and the shape of GISTs. Methods A total of 101 patients with primary GISTs were confirmed by pathology and immunohistochemistry and underwent enhanced CT examination. All lesions’ pathologic sizes were 1 to 10 cm. Points A and B were the extremities of the longest diameter (LD) of the tumor and points C and D the extremities of the small axis, which was the longest diameter perpendicular to AB. The four angles of the quadrangle ABCD were measured and each angle named by its summit (A, B, C, D). For regular lesions, we took angles A and B as big angle (BiA) and small angle (SmA). For irregular lesions, we compared A/B ratio and D/C ratio and selected the larger ratio for analysis. The chi-square test, t test, ROC analysis, and hierarchical or binary logistic regression analysis were used to analyze the data. Results The BiA/SmA ratio was an independent predictor for risk level of GISTs (p = 0.019). With threshold of BiA at 90.5°, BiA/SmA ratio at 1.35 and LD at 6.15 cm, the sensitivities for high-risk GISTs were 82.4%, 85.3%, and 83.8%, respectively; the specificities were 87.1%, 71%, and 77.4%, respectively; and the AUCs were 0.852, 0.818, and 0.844, respectively. LD could not effectively distinguish between intermediate-risk and high-risk GISTs, but BiA could (p < 0.05). Shape and Ki-67 were independent predictors of the mitotic value (p = 0.036 and p < 0.001, respectively), and the accuracy was 87.8%. Conclusions Quantifying tumor shape has better predictive efficacy than LD in predicting the risk level and mitotic value of GISTs, especially for high-risk grading and mitotic value > 5/50HPF. Key Points • The BiA/SmA ratio was an independent predictor affecting the risk level of GISTs. LD could not effectively distinguish between intermediate-risk and high-risk GISTs, but BiA could. • Shape and Ki-67 were independent predictors of the mitotic value. • The method for quantifying the tumor shape has better predictive efficacy than LD in predicting the risk level and mitotic value of GISTs.
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Affiliation(s)
- Sheng-Cai Wei
- Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No 440 Jiyan Road, Jinan, 250117, Shandong Province, People's Republic of China
| | - Liang Xu
- Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No 440 Jiyan Road, Jinan, 250117, Shandong Province, People's Republic of China
| | - Wan-Hu Li
- Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No 440 Jiyan Road, Jinan, 250117, Shandong Province, People's Republic of China
| | - Yun Li
- Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No 440 Jiyan Road, Jinan, 250117, Shandong Province, People's Republic of China
| | - Shou-Fang Guo
- Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No 440 Jiyan Road, Jinan, 250117, Shandong Province, People's Republic of China
| | - Xiao-Rong Sun
- Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No 440 Jiyan Road, Jinan, 250117, Shandong Province, People's Republic of China.
| | - Wen-Wu Li
- Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No 440 Jiyan Road, Jinan, 250117, Shandong Province, People's Republic of China.
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23
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Sollini M, Antunovic L, Chiti A, Kirienko M. Towards clinical application of image mining: a systematic review on artificial intelligence and radiomics. Eur J Nucl Med Mol Imaging 2019; 46:2656-2672. [PMID: 31214791 PMCID: PMC6879445 DOI: 10.1007/s00259-019-04372-x] [Citation(s) in RCA: 147] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 05/23/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE The aim of this systematic review was to analyse literature on artificial intelligence (AI) and radiomics, including all medical imaging modalities, for oncological and non-oncological applications, in order to assess how far the image mining research stands from routine medical application. To do this, we applied a trial phases classification inspired from the drug development process. METHODS Among the articles we considered for inclusion from PubMed were multimodality AI and radiomics investigations, with a validation analysis aimed at relevant clinical objectives. Quality assessment of selected papers was performed according to the QUADAS-2 criteria. We developed the phases classification criteria for image mining studies. RESULTS Overall 34,626 articles were retrieved, 300 were selected applying the inclusion/exclusion criteria, and 171 high-quality papers (QUADAS-2 ≥ 7) were identified and analysed. In 27/171 (16%), 141/171 (82%), and 3/171 (2%) studies the development of an AI-based algorithm, radiomics model, and a combined radiomics/AI approach, respectively, was described. A total of 26/27(96%) and 1/27 (4%) AI studies were classified as phase II and III, respectively. Consequently, 13/141 (9%), 10/141 (7%), 111/141 (79%), and 7/141 (5%) radiomics studies were classified as phase 0, I, II, and III, respectively. All three radiomics/AI studies were categorised as phase II trials. CONCLUSIONS The results of the studies are promising but still not mature enough for image mining tools to be implemented in the clinical setting and be widely used. The transfer learning from the well-known drug development process, with some specific adaptations to the image mining discipline could represent the most effective way for radiomics and AI algorithms to become the standard of care tools.
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Affiliation(s)
- Martina Sollini
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Lidija Antunovic
- Nuclear Medicine, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
| | - Arturo Chiti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
- Nuclear Medicine, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
| | - Margarita Kirienko
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.
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24
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Zhao W, Liu H, Leader JK, Wilson D, Meng X, Wang L, Chen LA, Pu J. Computerized identification of the vasculature surrounding a pulmonary nodule. Comput Med Imaging Graph 2019; 74:1-9. [PMID: 30903961 DOI: 10.1016/j.compmedimag.2019.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/01/2019] [Accepted: 03/06/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The idea of inferring the prognosis of lung tumor via its surrounding vasculature is novel, but not supported by available technology. In this study, we described and validated a computerized method to identify the vasculature surrounding a pulmonary nodule depicted on low-dose computed tomography (LDCT). MATERIALS AND METHODS The proposed computerized scheme identified the vessels surrounding a lung nodule by using novel computational geometric solutions and quantified them by decomposing the vessels into independent vessel branches. We validated this scheme by testing it on a dataset consisting of 100 chest CT examinations, with 50-paired benign and malignant nodules. Two experienced pulmonologists were asked to measure the vessel branches associated with a nodule under the aid of a visualization tool. We used the Bland-Altman plots and the concordance correlation coefficient (CCC) to assess the agreement between the results of the computer algorithm and two experienced pulmonologists. RESULTS Bland-Altman different analysis demonstrated a mean bias of 0.61 ± 4.17 in terms of vessel branches between the computer results and the human experts, while the inter-rater mean bias was -0.61 ± 1.60. The CCC-based agreements between the computer and the two raters were 0.90 / 0.86, 0.79 / 0.83 for benign and malignant nodules, respectively. CONCLUSION The small width of the limits of agreement between the computer algorithm and the human experts suggests that the results from the computer and the pulmonologist experts were relatively consistent, namely the computerized scheme is capable of reliably identifying the vasculature surrounding a nodule.
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Affiliation(s)
- Wei Zhao
- Respiratory Department, Chinese PLA General Hospital, Beijing, China
| | - Han Liu
- Departments of Radiology and Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Joseph K Leader
- Departments of Radiology and Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - David Wilson
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Xin Meng
- Departments of Radiology and Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Lei Wang
- Departments of Radiology and Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Liang-An Chen
- Respiratory Department, Chinese PLA General Hospital, Beijing, China
| | - Jiantao Pu
- Departments of Radiology and Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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25
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Beig N, Khorrami M, Alilou M, Prasanna P, Braman N, Orooji M, Rakshit S, Bera K, Rajiah P, Ginsberg J, Donatelli C, Thawani R, Yang M, Jacono F, Tiwari P, Velcheti V, Gilkeson R, Linden P, Madabhushi A. Perinodular and Intranodular Radiomic Features on Lung CT Images Distinguish Adenocarcinomas from Granulomas. Radiology 2019; 290:783-792. [PMID: 30561278 PMCID: PMC6394783 DOI: 10.1148/radiol.2018180910] [Citation(s) in RCA: 206] [Impact Index Per Article: 41.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 10/15/2018] [Accepted: 10/25/2018] [Indexed: 12/18/2022]
Abstract
Purpose To evaluate ability of radiomic (computer-extracted imaging) features to distinguish non-small cell lung cancer adenocarcinomas from granulomas at noncontrast CT. Materials and Methods For this retrospective study, screening or standard diagnostic noncontrast CT images were collected for 290 patients (mean age, 68 years; range, 18-92 years; 125 men [mean age, 67 years; range, 18-90 years] and 165 women [mean age, 68 years; range, 33-92 years]) from two institutions between 2007 and 2013. Histopathologic analysis was available for one nodule per patient. Corresponding nodule of interest was identified on axial CT images by a radiologist with manual annotation. Nodule shape, wavelet (Gabor), and texture-based (Haralick and Laws energy) features were extracted from intra- and perinodular regions. Features were pruned to train machine learning classifiers with 145 patients. In a test set of 145 patients, classifier results were compared against a convolutional neural network (CNN) and diagnostic readings of two radiologists. Results Support vector machine classifier with intranodular radiomic features achieved an area under the receiver operating characteristic curve (AUC) of 0.75 on the test set. Combining radiomics of intranodular with perinodular regions improved the AUC to 0.80. On the same test set, CNN resulted in an AUC of 0.76. Radiologist readers achieved AUCs of 0.61 and 0.60, respectively. Conclusion Radiomic features from intranodular and perinodular regions of nodules can distinguish non-small cell lung cancer adenocarcinomas from benign granulomas at noncontrast CT. © RSNA, 2018 Online supplemental material is available for this article. See also the editorial by Nishino in this issue.
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Affiliation(s)
- Niha Beig
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Mohammadhadi Khorrami
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Mehdi Alilou
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Prateek Prasanna
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Nathaniel Braman
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Mahdi Orooji
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Sagar Rakshit
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Kaustav Bera
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Prabhakar Rajiah
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Jennifer Ginsberg
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Christopher Donatelli
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Rajat Thawani
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Michael Yang
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Frank Jacono
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Pallavi Tiwari
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Vamsidhar Velcheti
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Robert Gilkeson
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Philip Linden
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
| | - Anant Madabhushi
- From the Department of Biomedical Engineering, Case Western Reserve
University, 2071 Martin Luther King Dr, Wickenden 523, Cleveland, OH 44106-7207
(N. Beig, M.K., M.A., P.P., N. Braman, M.O., K.B., P.T., A.M.); Taussig Cancer
Institute–Cleveland Clinic, Cleveland, Ohio (S.R.); Division of Thoracic
and Esophageal Surgery (J.G., P.L.), Division of Pulmonary Critical Care and
Sleep Medicine (C.D., F.J.), Department of Pathology (M.Y.), and Department of
Radiology (R.G.), University Hospitals of Cleveland, Cleveland, Ohio; Pulmonary
Section, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio (F.J.);
Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (P.R.);
Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY (R.T.);
and Hematology and Oncology, New York University, Perlmutter Cancer Center, New
York, NY (V.V.)
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Quantitative vessel tortuosity: A potential CT imaging biomarker for distinguishing lung granulomas from adenocarcinomas. Sci Rep 2018; 8:15290. [PMID: 30327507 PMCID: PMC6191462 DOI: 10.1038/s41598-018-33473-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 09/24/2018] [Indexed: 12/17/2022] Open
Abstract
Adenocarcinomas and active granulomas can both have a spiculated appearance on computed tomography (CT) and both are often fluorodeoxyglucose (FDG) avid on positron emission tomography (PET) scan, making them difficult to distinguish. Consequently, patients with benign granulomas are often subjected to invasive surgical biopsies or resections. In this study, quantitative vessel tortuosity (QVT), a novel CT imaging biomarker to distinguish between benign granulomas and adenocarcinomas on routine non-contrast lung CT scans is introduced. Our study comprised of CT scans of 290 patients from two different institutions, one cohort for training (N = 145) and the other (N = 145) for independent validation. In conjunction with a machine learning classifier, the top informative and stable QVT features yielded an area under receiver operating characteristic curve (ROC AUC) of 0.85 in the independent validation set. On the same cohort, the corresponding AUCs for two human experts including a radiologist and a pulmonologist were found to be 0.61 and 0.60, respectively. QVT features also outperformed well known shape and textural radiomic features which had a maximum AUC of 0.73 (p-value = 0.002), as well as features learned using a convolutional neural network AUC = 0.76 (p-value = 0.028). Our results suggest that QVT features could potentially serve as a non-invasive imaging biomarker to distinguish granulomas from adenocarcinomas on non-contrast CT scans.
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Kandathil A, Kay F, Batra K, Saboo SS, Rajiah P. Advances in Computed Tomography in Thoracic Imaging. Semin Roentgenol 2018; 53:157-170. [PMID: 29861007 DOI: 10.1053/j.ro.2018.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Asha Kandathil
- Cardiothoracic Imaging, Radiology Department, UT Southwestern Medical Center, Dallas, TX
| | - Fernando Kay
- Cardiothoracic Imaging, Radiology Department, UT Southwestern Medical Center, Dallas, TX
| | - Kiran Batra
- Cardiothoracic Imaging, Radiology Department, UT Southwestern Medical Center, Dallas, TX
| | - Sachin S Saboo
- Cardiothoracic Imaging, Radiology Department, UT Southwestern Medical Center, Dallas, TX
| | - Prabhakar Rajiah
- Cardiothoracic Imaging, Radiology Department, UT Southwestern Medical Center, Dallas, TX.
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28
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Bera K, Velcheti V, Madabhushi A. Novel Quantitative Imaging for Predicting Response to Therapy: Techniques and Clinical Applications. Am Soc Clin Oncol Educ Book 2018; 38:1008-1018. [PMID: 30231314 PMCID: PMC6152883 DOI: 10.1200/edbk_199747] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The current standard of Response Evaluation Criteria in Solid Tumors (RECIST)-based tumor response evaluation is limited in its ability to accurately monitor treatment response. Radiomics, an approach involving computerized extraction of several quantitative imaging features, has shown promise in predicting as well as monitoring response to therapy. In this article, we provide a brief overview of radiomic approaches and the various analytical methods and techniques, specifically in the context of predicting and monitoring treatment response for non-small cell lung cancer (NSCLC). We briefly summarize some of the various types of radiomic features, including tumor shape and textural patterns, both within the tumor and within the adjacent tumor microenvironment. Additionally, we also discuss work in delta-radiomics or change in radiomic features (e.g., texture within the nodule) across longitudinally interspersed images in time for monitoring changes in therapy. We discuss the utility of these approaches for NSCLC, specifically the role of radiomics as a prognostic marker for treatment effectiveness and early therapy response, including chemoradiation, immunotherapy, and trimodality therapy.
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Affiliation(s)
- Kaustav Bera
- From the Case Western Reserve University, Cleveland, OH; Cleveland Clinic Foundation, Cleveland, OH
| | - Vamsidhar Velcheti
- From the Case Western Reserve University, Cleveland, OH; Cleveland Clinic Foundation, Cleveland, OH
| | - Anant Madabhushi
- From the Case Western Reserve University, Cleveland, OH; Cleveland Clinic Foundation, Cleveland, OH
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29
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Thawani R, McLane M, Beig N, Ghose S, Prasanna P, Velcheti V, Madabhushi A. Radiomics and radiogenomics in lung cancer: A review for the clinician. Lung Cancer 2018; 115:34-41. [DOI: 10.1016/j.lungcan.2017.10.015] [Citation(s) in RCA: 216] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/14/2017] [Accepted: 10/29/2017] [Indexed: 10/18/2022]
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