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Wu Y, Qi Q, Qi S, Yang L, Wang H, Yu H, Li J, Wang G, Zhang P, Liang Z, Chen R. Classification of COVID-19 from community-acquired pneumonia: Boosting the performance with capsule network and maximum intensity projection image of CT scans. Comput Biol Med 2023; 154:106567. [PMID: 36738705 PMCID: PMC9869624 DOI: 10.1016/j.compbiomed.2023.106567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/30/2022] [Accepted: 01/22/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) and community-acquired pneumonia (CAP) present a high degree of similarity in chest computed tomography (CT) images. Therefore, a procedure for accurately and automatically distinguishing between them is crucial. METHODS A deep learning method for distinguishing COVID-19 from CAP is developed using maximum intensity projection (MIP) images from CT scans. LinkNet is employed for lung segmentation of chest CT images. MIP images are produced by superposing the maximum gray of intrapulmonary CT values. The MIP images are input into a capsule network for patient-level pred iction and diagnosis of COVID-19. The network is trained using 333 CT scans (168 COVID-19/165 CAP) and validated on three external datasets containing 3581 CT scans (2110 COVID-19/1471 CAP). RESULTS LinkNet achieves the highest Dice coefficient of 0.983 for lung segmentation. For the classification of COVID-19 and CAP, the capsule network with the DenseNet-121 feature extractor outperforms ResNet-50 and Inception-V3, achieving an accuracy of 0.970 on the training dataset. Without MIP or the capsule network, the accuracy decreases to 0.857 and 0.818, respectively. Accuracy scores of 0.961, 0.997, and 0.949 are achieved on the external validation datasets. The proposed method has higher or comparable sensitivity compared with ten state-of-the-art methods. CONCLUSIONS The proposed method illustrates the feasibility of applying MIP images from CT scans to distinguish COVID-19 from CAP using capsule networks. MIP images provide conspicuous benefits when exploiting deep learning to detect COVID-19 lesions from CT scans and the capsule network improves COVID-19 diagnosis.
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Affiliation(s)
- Yanan Wu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China; Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, China.
| | - Qianqian Qi
- Research Center for Healthcare Data Science, Zhejiang Lab, Hangzhou, China.
| | - Shouliang Qi
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China; Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, China.
| | - Liming Yang
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
| | - Hanlin Wang
- Department of Radiology, General Hospital of the Yangtze River Shipping, Wuhan, China.
| | - Hui Yu
- General Practice Center, The Seventh Affiliated Hospital, Southern Medical University, Guangzhou, China.
| | - Jianpeng Li
- Department of Radiology, Affiliated Dongguan Hospital, Southern Medical University, Dongguan, China.
| | - Gang Wang
- Department of Radiology, Affiliated Dongguan Hospital, Southern Medical University, Dongguan, China.
| | - Ping Zhang
- Department of Pulmonary and Critical Care Medicine, Affiliated Dongguan Hospital, Southern Medical University, Dongguan, China.
| | - Zhenyu Liang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Rongchang Chen
- Key Laboratory of Respiratory Disease of Shenzhen, Shenzhen Institute of Respiratory Disease, Shenzhen People's Hospital (Second Affiliated Hospital of Jinan University, First Affiliated Hospital of South University of Science and Technology of China), Shenzhen, China.
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Lee JJB, Suh YJ, Oh C, Lee BM, Kim JS, Chang Y, Jeon YJ, Kim JY, Park SY, Chang JS. Automated Computer-aided Detection of Lung Nodules in Metastatic Colorectal Cancer Patients for the Identification of Pulmonary Oligometastatic Disease. Int J Radiat Oncol Biol Phys 2022; 114:1045-1052. [PMID: 36028066 DOI: 10.1016/j.ijrobp.2022.08.042] [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: 02/17/2022] [Revised: 08/09/2022] [Accepted: 08/13/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aims to explore the possibility and clinical utility of existing artificial intelligence (AI)-based computer-aided detection (CAD) of lung nodules to identify pulmonary oligometastases. PATIENTS AND METHODS The chest computed tomography (CT) scans of patients with lung metastasis from colorectal cancer between March 2006 and November 2018 were analyzed. The patients were selected from a database of 1,395 patients and studied in two cohorts. The first cohort included 50 patients and the CT scans of these patients were independently evaluated for lung nodule (≥3 mm) detection by a CAD-assisted radiation oncologist (CAD-RO) as well as an expert radiologist. Inter-observer variability in additional two radiation oncologists and two thoracic surgeons was also measured. In the second cohort of 305 patients, survival outcomes were evaluated based on the number of CAD-RO-detected nodules. RESULTS In the first cohort, the sensitivity and specificity of the CAD-RO for the identification of oligometastatic disease (OMD) from varying criteria by ≤2 nodules, ≤3 nodules, ≤4 nodules, and ≤5 nodules were 71.9% and 88.9%; 82.9% and 93.3%; 97.1% and 73.3%; and 97.5% and 90.0%, respectively. The sensitivity of the CAD-RO in the nodule detection compared with the radiologist was 81.6%. The average (standard deviation) sensitivity in inter-observer variability analysis was 80.0% (3.7%). In the second cohort, the 5-year survival rates of patients with 1, 2, 3, 4, or ≥5 metastatic nodules were 75.2%, 52.9%, 45.7%, 29.1%, and 22.7%, respectively. CONCLUSIONS Proper identification of the pulmonary OMD and the correlation between the number of CAD-RO-detected nodules and survival suggest the potential practicality of AI in OMD recognition. Developing a deep learning-based model specific to the metastatic setting, which enables a quick estimation of disease burden and identification of OMD, is underway.
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Affiliation(s)
- Jason Joon Bock Lee
- Deparment of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Joo Suh
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Caleb Oh
- Deparment of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Byung Min Lee
- Deparment of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Sung Kim
- Deparment of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | | | - Yeong Jeong Jeon
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Young Kim
- Deparment of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seong Yong Park
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
| | - Jee Suk Chang
- Deparment of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
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Naeem MQ, Darira J, Ahmed MS, Hamid K, Ali M, Shazlee MK. Comparison of Maximum Intensity Projection and Volume Rendering in Detecting Pulmonary Nodules on Multidetector Computed Tomography. Cureus 2021; 13:e14025. [PMID: 33898115 PMCID: PMC8057938 DOI: 10.7759/cureus.14025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Lung cancer is the most common cancer overall, and the foremost cause of cancer-related mortality. Almost all lung cancers evolve from pulmonary nodules. As multidetector CT (MDCT) scanners are now widely available, there is an increased rate of detection of pulmonary nodules. It is of utmost importance to evaluate pulmonary nodules to rule out the possibility of neoplastic diseases. With advancements in technology, there are various manual and automatic analytic software providing a wide range of post-processing techniques. Maximum intensity projection (MIP) and volume rendering (VR) techniques have been analyzed previously regarding pulmonary nodules but there is a scarcity of data in terms of low-density nodules. This study aims to delineate the comparison and supremacy of both techniques in terms of low-density nodules. Methodology The current prospective study was conducted from June 2019 to June 2020 in the Radiology Department at Dr. Ziauddin Hospital, Karachi. Chest CT scans were performed on 16 slice MDCT (Alexion 16 Multi-slice, Toshiba Medical System Corporation, Houston, TX). A consultant radiologist of six years experience and a postgraduate trainee of three years experience analyzed each patient on a workstation (Vitrea 6.2.0, Vital Images, Minnetonka, MN). SPSS 23.0 (SPSS Inc., Chicago, IL) was incorporated for data analysis. Data were expressed in the median and interquartile range (IQR). Data collected for this study were analyzed using analyzing the median difference in nodule count using Wilcoxon's signed-rank test. A p-value of <0.05 was considered significant. Results After informed consent, 236 patients were recruited for the study. MIP outperformed VR in terms of nodule detection and low-density nodules at each evaluated slab thicknesses (p<0.001). A 10-mm MIP was superior to all other techniques in terms of detection of pulmonary nodules and low-density nodules (p<0.001). MIP was also considered an easier technique as there was excellent inter-rater reliability and agreement. Conclusion This study is robust evidence regarding the supremacy of MIP. MIP outperformed VR on every slab thicknesses. The 10-mm MIP technique was superior to all others evaluated and was recorded to be an easier analyzing technique.
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Affiliation(s)
| | - Jaideep Darira
- Diagnostic Radiology, Dr. Ziauddin Hospital, Karachi, PAK
| | | | - Kamran Hamid
- Diagnostic Radiology, Dr. Ziauddin Hospital, Karachi, PAK
| | - Muhammad Ali
- Diagnostic Radiology, Dr. Ziauddin Hospital, Karachi, PAK
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European guideline for imaging in paediatric and adolescent rhabdomyosarcoma - joint statement by the European Paediatric Soft Tissue Sarcoma Study Group, the Cooperative Weichteilsarkom Studiengruppe and the Oncology Task Force of the European Society of Paediatric Radiology. Pediatr Radiol 2021; 51:1940-1951. [PMID: 34137936 PMCID: PMC8426307 DOI: 10.1007/s00247-021-05081-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 01/25/2021] [Accepted: 04/14/2021] [Indexed: 02/08/2023]
Abstract
Appropriate imaging is essential in the treatment of children and adolescents with rhabdomyosarcoma. For adequate stratification and optimal individualised local treatment utilising surgery and radiotherapy, high-quality imaging is crucial. The paediatric radiologist, therefore, is an essential member of the multi-disciplinary team providing clinical care and research. This manuscript presents the European rhabdomyosarcoma imaging guideline, based on the recently developed guideline of the European Paediatric Soft Tissue Sarcoma Study Group (EpSSG) Imaging Committee. This guideline was developed in collaboration between the EpSSG Imaging Committee, the Cooperative Weichteilsarkom Studiengruppe (CWS) Imaging Group, and the Oncology Task Force of the European Society of Paediatric Radiology (ESPR). MRI is recommended, at diagnosis and follow-up, for the evaluation of the primary tumour and its relationship to surrounding tissues, including assessment of neurovascular structures and loco-regional lymphadenopathy. Chest CT along with [F-18]2-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/CT or PET/MRI are recommended for the detection and evaluation of loco-regional and distant metastatic disease. Guidance on the estimation of treatment response, optimal long-term follow-up, technical imaging settings and standardised reporting are described. This European imaging guideline outlines the recommendations for imaging in children and adolescents with rhabdomyosarcoma, with the aim to harmonise imaging and to advance patient care.
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Zheng S, Cui X, Vonder M, Veldhuis RNJ, Ye Z, Vliegenthart R, Oudkerk M, van Ooijen PMA. Deep learning-based pulmonary nodule detection: Effect of slab thickness in maximum intensity projections at the nodule candidate detection stage. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 196:105620. [PMID: 32615493 DOI: 10.1016/j.cmpb.2020.105620] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE To investigate the effect of the slab thickness in maximum intensity projections (MIPs) on the candidate detection performance of a deep learning-based computer-aided detection (DL-CAD) system for pulmonary nodule detection in CT scans. METHODS The public LUNA16 dataset includes 888 CT scans with 1186 nodules annotated by four radiologists. From those scans, MIP images were reconstructed with slab thicknesses of 5 to 50 mm (at 5 mm intervals) and 3 to 13 mm (at 2 mm intervals). The architecture in the nodule candidate detection part of the DL-CAD system was trained separately using MIP images with various slab thicknesses. Based on ten-fold cross-validation, the sensitivity and the F2 score were determined to evaluate the performance of using each slab thickness at the nodule candidate detection stage. The free-response receiver operating characteristic (FROC) curve was used to assess the performance of the whole DL-CAD system that took the results combined from 16 MIP slab thickness settings. RESULTS At the nodule candidate detection stage, the combination of results from 16 MIP slab thickness settings showed a high sensitivity of 98.0% with 46 false positives (FPs) per scan. Regarding a single MIP slab thickness of 10 mm, the highest sensitivity of 90.0% with 8 FPs/scan was reached before false positive reduction. The sensitivity increased (82.8% to 90.0%) for slab thickness of 1 to 10 mm and decreased (88.7% to 76.6%) for slab thickness of 15-50 mm. The number of FPs was decreasing with increasing slab thickness, but was stable at 5 FPs/scan at a slab thickness of 30 mm or more. After false positive reduction, the DL-CAD system, utilizing 16 MIP slab thickness settings, had the sensitivity of 94.4% with 1 FP/scan. CONCLUSIONS The utilization of multi-MIP images could improve the performance at the nodule candidate detection stage, even for the whole DL-CAD system. For a single slab thickness of 10 mm, the highest sensitivity for pulmonary nodule detection was reached at the nodule candidate detection stage, similar to the slab thickness usually applied by radiologists.
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Affiliation(s)
- Sunyi Zheng
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Xiaonan Cui
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre of Cancer, Tianjin, China
| | - Marleen Vonder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Zhaoxiang Ye
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre of Cancer, Tianjin, China
| | - Rozemarijn Vliegenthart
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Peter M A van Ooijen
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Jabeen N, Qureshi R, Sattar A, Baloch M. Diagnostic Accuracy of Maximum Intensity Projection in Diagnosis of Malignant Pulmonary Nodules. Cureus 2019; 11:e6120. [PMID: 31886058 PMCID: PMC6903899 DOI: 10.7759/cureus.6120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introduction Pulmonary nodules are frequently encountered during chest imaging, and its evaluation is usually done by chest radiograph and computed tomography (CT) scan of chest. High resolution of multidetector CT (MDCT) has improved the nodule detection. Post processing techniques such as maximum intensity projection (MIP) can further improve the sensitivity of MDCT for nodule detection. Failure to diagnose malignancy in pulmonary nodules can delay the treatment. Therefore, the aim of this study was to determine the diagnostic accuracy of MIP in the diagnosis of malignant pulmonary nodules taking histopathology findings as gold standard. Materials and methods A retrospective cross-sectional study was conducted at Dow Institute of Radiology, Dow University of Health Sciences, from 1 December 2018 till 30 June 2019. Both male and female patients aged 18 years and above who underwent CT scan of chest with suspicion of pulmonary nodules were included. Patients already diagnosed with malignant pulmonary nodules and presenting for follow-up were excluded. Contrast-enhanced CT chest was performed on a multi-slice scanner. MIP reconstruction and evaluation was performed on the workstation. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of MIP were calculated taking histopathology findings as gold standard. Results A total of 202 patients were included in this study. The mean age of the patients was 55.87 ± 13.08 years. A total of 103 patients (51.0%) were males and 99 patients (49.0%) were females. There were 131 (64.9%) nodules with smooth margins and 71 (35.1%) nodules with irregular margins. The mean size of nodule was 3.1 ± 0.7 cm. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of MIP in diagnosing malignant pulmonary nodules were found to be 85.82%, 82.35%, 90.55%, 74.67%, and 84.65%, respectively, taking histopathology findings as gold standard. The nodules >3 cm in size had a higher sensitivity for diagnosing malignant pulmonary nodules. Smooth margin nodule had high sensitivity, specificity, and diagnostic accuracy for diagnosing malignant pulmonary nodules. Conclusion MIP images have high sensitivity, specificity, and diagnostic accuracy in the diagnosis of malignant pulmonary nodules. The utilization of MIP images can aid in the detection of malignant pulmonary nodules and help in formulating early treatment strategies for the patients. Other post processing techniques such as volume rendering and computer-aided detection can help in further improving patient care.
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Affiliation(s)
- Naila Jabeen
- Radiology, Dow University of Health Sciences, Karachi, PAK
| | - Ruby Qureshi
- Radiology, Dow University of Health Sciences, Karachi, PAK
| | - Amjad Sattar
- Radiology, Dow University of Health Sciences, Karachi, PAK
| | - Musarat Baloch
- Internal Medicine, Liaquat University of Medical and Health Sciences, Hyderabad/Jamshoro, PAK
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Wood DE, Kazerooni EA, Baum SL, Eapen GA, Ettinger DS, Hou L, Jackman DM, Klippenstein D, Kumar R, Lackner RP, Leard LE, Lennes IT, Leung ANC, Makani SS, Massion PP, Mazzone P, Merritt RE, Meyers BF, Midthun DE, Pipavath S, Pratt C, Reddy C, Reid ME, Rotter AJ, Sachs PB, Schabath MB, Schiebler ML, Tong BC, Travis WD, Wei B, Yang SC, Gregory KM, Hughes M. Lung Cancer Screening, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2019; 16:412-441. [PMID: 29632061 DOI: 10.6004/jnccn.2018.0020] [Citation(s) in RCA: 383] [Impact Index Per Article: 76.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Lung cancer is the leading cause of cancer-related mortality in the United States and worldwide. Early detection of lung cancer is an important opportunity for decreasing mortality. Data support using low-dose computed tomography (LDCT) of the chest to screen select patients who are at high risk for lung cancer. Lung screening is covered under the Affordable Care Act for individuals with high-risk factors. The Centers for Medicare & Medicaid Services (CMS) covers annual screening LDCT for appropriate Medicare beneficiaries at high risk for lung cancer if they also receive counseling and participate in shared decision-making before screening. The complete version of the NCCN Guidelines for Lung Cancer Screening provides recommendations for initial and subsequent LDCT screening and provides more detail about LDCT screening. This manuscript focuses on identifying patients at high risk for lung cancer who are candidates for LDCT of the chest and on evaluating initial screening findings.
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Effect of Slab Thickness on the Detection of Pulmonary Nodules by Use of CT Maximum and Minimum Intensity Projection. AJR Am J Roentgenol 2019; 213:562-567. [PMID: 31063429 DOI: 10.2214/ajr.19.21325] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Weber NM, Koo CW, Yu L, Bartholmai BJ, Halaweish AF, McCollough CH, Fletcher JG. Breathe New Life Into Your Chest CT Exams: Using Advanced Acquisition and Postprocessing Techniques. Curr Probl Diagn Radiol 2019; 48:152-160. [DOI: 10.1067/j.cpradiol.2018.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/06/2018] [Accepted: 10/16/2018] [Indexed: 11/22/2022]
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Yoshida Y, Sakane T, Isogai J, Suzuki Y, Miki S, Nomura Y, Nakajima J. Computer-assisted detection of metastatic lung tumors on computed tomography. Asian Cardiovasc Thorac Ann 2019; 27:199-207. [PMID: 30789307 DOI: 10.1177/0218492319831836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND This retrospective study examined the performance of computer-assisted detection in the identification of pulmonary metastases. METHODS Fifty-five patients (41.8% male) who underwent surgery for metastatic lung tumors in our hospital from 2005 to 2012 were included. Computer-assisted detection software configured to display the top five nodule candidates according to likelihood was applied as the first reader for the preoperative computed tomography images. Results from the software were classified as "metastatic nodule", "benign nodule", or "false-positive finding" by two observers. RESULTS Computer-assisted detection identified 85.3% (64/75) of pulmonary metastases that radiologists had detected, and 3 more (4%, 3/75) that radiologists had overlooked. Nodule candidates identified by computer-assisted detection included 86 benign nodules (median size 3.1 mm, range 1.2-18.7 mm) and 121 false-positive findings. CONCLUSIONS Computer-assisted detection identified pulmonary metastases overlooked by radiologists. However, this was at the cost of identifying a substantial number of benign nodules and false-positive findings.
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Affiliation(s)
| | - Tomoya Sakane
- 2 Department of Radiology, Asahi General Hospital, Chiba, Japan
| | - Jun Isogai
- 2 Department of Radiology, Asahi General Hospital, Chiba, Japan
| | - Yoshio Suzuki
- 3 Department of Pathology, Asahi General Hospital, Chiba, Japan
| | - Soichiro Miki
- 4 Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yukihiro Nomura
- 4 Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Jun Nakajima
- 5 Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan
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State-of-the-Art Diagnosis and Treatment of Melanoma. J Comput Assist Tomogr 2018; 42:331-339. [DOI: 10.1097/rct.0000000000000697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rydzak CE, Armato SG, Avila RS, Mulshine JL, Yankelevitz DF, Gierada DS. Quality assurance and quantitative imaging biomarkers in low-dose CT lung cancer screening. Br J Radiol 2017; 91:20170401. [PMID: 28830225 DOI: 10.1259/bjr.20170401] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
After years of assessment through controlled clinical trials, low-dose CT screening for lung cancer is becoming part of clinical practice. As with any cancer screening test, those undergoing lung cancer screening are not being evaluated for concerning signs or symptoms, but are generally in good health and proactively trying to prevent premature death. Given the resultant obligation to achieve the screening aim of early diagnosis while also minimizing the potential for morbidity from workup of indeterminate but ultimately benign screening abnormalities, careful implementation of screening with conformance to currently recognized best practices and a focus on quality assurance is essential. In this review, we address the importance of each component of the screening process to optimize the effectiveness of CT screening, discussing options for quality assurance at each step. We also discuss the potential added advantages, quality assurance requirements and current status of quantitative imaging biomarkers related to lung cancer screening. Finally, we highlight suggestions for improvements and needs for further evidence in evaluating the performance of CT screening as it transitions from the research trial setting into daily clinical practice.
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Affiliation(s)
- Chara E Rydzak
- 1 Mallinckrodt Institute of Radiology, Washington University School of Medicine , St. Louis, MO , USA
| | - Samuel G Armato
- 2 Department of Radiology, University of Chicago , Chicago, IL , USA
| | | | - James L Mulshine
- 4 Department of Internal Medicine, Rush University , Chicago, IL , USA
| | - David F Yankelevitz
- 5 Department of Radiology, Icahn School of Medicine at Mount Sinai , New York, NY , USA
| | - David S Gierada
- 1 Mallinckrodt Institute of Radiology, Washington University School of Medicine , St. Louis, MO , USA
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Bae YJ, Choi BS, Lee KM, Yoon YH, Sunwoo L, Jung C, Kim JH. Efficacy of Maximum Intensity Projection of Contrast-Enhanced 3D Turbo-Spin Echo Imaging with Improved Motion-Sensitized Driven-Equilibrium Preparation in the Detection of Brain Metastases. Korean J Radiol 2017; 18:699-709. [PMID: 28670165 PMCID: PMC5447646 DOI: 10.3348/kjr.2017.18.4.699] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/16/2017] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate the diagnostic benefits of 5-mm maximum intensity projection of improved motion-sensitized driven-equilibrium prepared contrast-enhanced 3D T1-weighted turbo-spin echo imaging (MIP iMSDE-TSE) in the detection of brain metastases. The imaging technique was compared with 1-mm images of iMSDE-TSE (non-MIP iMSDE-TSE), 1-mm contrast-enhanced 3D T1-weighted gradient-echo imaging (non-MIP 3D-GRE), and 5-mm MIP 3D-GRE. Materials and Methods From October 2014 to July 2015, 30 patients with 460 enhancing brain metastases (size > 3 mm, n = 150; size ≤ 3 mm, n = 310) were scanned with non-MIP iMSDE-TSE and non-MIP 3D-GRE. We then performed 5-mm MIP reconstruction of these images. Two independent neuroradiologists reviewed these four sequences. Their diagnostic performance was compared using the following parameters: sensitivity, reading time, and figure of merit (FOM) derived by jackknife alternative free-response receiver operating characteristic analysis. Interobserver agreement was also tested. Results The mean FOM (all lesions, 0.984; lesions ≤ 3 mm, 0.980) and sensitivity ([reader 1: all lesions, 97.3%; lesions ≤ 3 mm, 96.2%], [reader 2: all lesions, 97.0%; lesions ≤ 3 mm, 95.8%]) of MIP iMSDE-TSE was comparable to the mean FOM (0.985, 0.977) and sensitivity ([reader 1: 96.7, 99.0%], [reader 2: 97, 95.3%]) of non-MIP iMSDE-TSE, but they were superior to those of non-MIP and MIP 3D-GREs (all, p < 0.001). The reading time of MIP iMSDE-TSE (reader 1: 47.7 ± 35.9 seconds; reader 2: 44.7 ± 23.6 seconds) was significantly shorter than that of non-MIP iMSDE-TSE (reader 1: 78.8 ± 43.7 seconds, p = 0.01; reader 2: 82.9 ± 39.9 seconds, p < 0.001). Interobserver agreement was excellent (κ > 0.75) for all lesions in both sequences. Conclusion MIP iMSDE-TSE showed high detectability of brain metastases. Its detectability was comparable to that of non-MIP iMSDE-TSE, but it was superior to the detectability of non-MIP/MIP 3D-GREs. With a shorter reading time, the false-positive results of MIP iMSDE-TSE were greater. We suggest that MIP iMSDE-TSE can provide high diagnostic performance and low false-positive rates when combined with 1-mm sequences.
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Affiliation(s)
- Yun Jung Bae
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Byung Se Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Kyung Mi Lee
- Department of Radiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Korea
| | - Yeon Hong Yoon
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Leonard Sunwoo
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Cheolkyu Jung
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
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Proton Magnetic Resonance Imaging for Initial Assessment of Isolated Mycobacterium avium Complex Pneumonia. Ann Am Thorac Soc 2016; 13:49-57. [PMID: 26633593 DOI: 10.1513/annalsats.201505-282oc] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Computed tomographic (CT) radiography is the reference standard for imaging Mycobacterium avium complex (MAC) lung infection. Magnetic resonance imaging (MRI) has been shown to be comparable to CT for characterizing other pulmonary inflammatory conditions, but has not been rigorously tested for imaging MAC pneumonia. OBJECTIVES To determine the feasibility of pulmonary MRI for imaging MAC pneumonia and to assess the degree of agreement between MRI and CT for assessing the anatomic features and lobar extent of MAC lung infections. METHODS Twenty-five subjects with culture-confirmed MAC pneumonia and no identified coinfecting organisms were evaluated by thoracic MRI and then by chest CT imaging performed up to 1 week later. After deidentification, first the MRI and then the CT scans were scored 2 weeks apart by two chest radiologists working independently of one another. Discrepancies were resolved by a third chest radiologist. The scans were scored for bronchiectasis, consolidation or atelectasis, abscess or sacculation, nodules, and mucus plugging using a three-point lobar scale (absent, <50% of lobe, and >50% of lobe). Agreement analyses and ordinary least products regressions were performed. MEASUREMENTS AND MAIN RESULTS A fixed bias was found between total CT and MRI scores, with CT scoring higher on average (median difference: 4 on a scale of 48; interquartile range: 3, 6). Fixed biases were found for bronchiectasis and consolidation or atelectasis subscale scores. Both fixed and proportional biases were found between CT and MRI mucus plugging scores. No bias was found between CT and MRI nodule scores. There was nearly perfect lobar percent agreement for more conspicuous findings such as consolidation or atelectasis and abscess or sacculation. CONCLUSIONS In this exploratory study of 25 adult patients with culture-proven MAC lung infection, we found moderate agreement between MRI and CT for assessing the anatomic features and lobar extent of disease. Given the feasibility of chest MRI for this condition, future work is warranted to assess the clinical impact of MRI compared with CT in assessing progression of untreated MAC infection and response to treatment over time.
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Advanced imaging tools in pulmonary nodule detection and surveillance. Clin Imaging 2016; 40:296-301. [PMID: 26916752 DOI: 10.1016/j.clinimag.2016.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 01/27/2016] [Accepted: 01/29/2016] [Indexed: 11/23/2022]
Abstract
Lung cancer is a leading cause of death worldwide. The National Lung Screening Trial has demonstrated that lung cancer screening can reduce lung cancer specific and all cause mortality. With approval of national coverage for lung cancer screening, it is expected that an increase in exams related to pulmonary nodule detection and surveillance will ensue. Advanced imaging technologies for nodule detection and surveillance will be more important than ever. While computed tomography (CT) remains the modality of choice, other emerging modalities such as magnetic resonance imaging provides viable alternatives to CT.
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Callister MEJ, Baldwin DR, Akram AR, Barnard S, Cane P, Draffan J, Franks K, Gleeson F, Graham R, Malhotra P, Prokop M, Rodger K, Subesinghe M, Waller D, Woolhouse I. British Thoracic Society guidelines for the investigation and management of pulmonary nodules. Thorax 2015; 70 Suppl 2:ii1-ii54. [PMID: 26082159 DOI: 10.1136/thoraxjnl-2015-207168] [Citation(s) in RCA: 560] [Impact Index Per Article: 62.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- M E J Callister
- Department of Respiratory Medicine, Leeds Teaching Hospitals, Leeds, UK
| | - D R Baldwin
- Nottingham University Hospitals, Nottingham, UK
| | - A R Akram
- Royal Infirmary of Edinburgh, Edinburgh, UK
| | - S Barnard
- Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle, UK
| | - P Cane
- Department of Histopathology, St Thomas' Hospital, London, UK
| | - J Draffan
- University Hospital of North Tees, Stockton on Tees, UK
| | - K Franks
- Clinical Oncology, St James's Institute of Oncology, Leeds, UK
| | - F Gleeson
- Department of Radiology, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - P Malhotra
- St Helens and Knowsley Teaching Hospitals NHS Trust, UK
| | - M Prokop
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - K Rodger
- Respiratory Medicine, St James's University Hospital, Leeds, UK
| | - M Subesinghe
- Department of Radiology, Churchill Hospital, Oxford, UK
| | - D Waller
- Department of Thoracic Surgery, Glenfield Hospital, Leicester, UK
| | - I Woolhouse
- Department of Respiratory Medicine, University Hospitals of Birmingham, Birmingham, UK
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Krüger M, Zinne N, Shin H, Zhang R, Biancosino C, Kropivnitskaja I, Länger F, Haverich A, Dettmer S. Minimal-invasive Thoraxchirurgie. Chirurg 2015; 87:136-43. [DOI: 10.1007/s00104-015-0013-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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18
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ACR-STR practice parameter for the performance and reporting of lung cancer screening thoracic computed tomography (CT): 2014 (Resolution 4). J Thorac Imaging 2015; 29:310-6. [PMID: 24992501 DOI: 10.1097/rti.0000000000000097] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Lee KH, Goo JM, Lee SM, Park CM, Bahn YE, Kim H, Song YS, Hwang EJ. Digital tomosynthesis for evaluating metastatic lung nodules: nodule visibility, learning curves, and reading times. Korean J Radiol 2015; 16:430-9. [PMID: 25741205 PMCID: PMC4347279 DOI: 10.3348/kjr.2015.16.2.430] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 11/30/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate nodule visibility, learning curves, and reading times for digital tomosynthesis (DT). MATERIALS AND METHODS We included 80 patients who underwent computed tomography (CT) and DT before pulmonary metastasectomy. One experienced chest radiologist annotated all visible nodules on thin-section CT scans using computer-aided detection software. Two radiologists used CT as the reference standard and retrospectively graded the visibility of nodules on DT. Nodule detection performance was evaluated in four sessions of 20 cases each by six readers. After each session, readers were unblinded to the DT images by revealing the true-positive markings and were instructed to self-analyze their own misreads. Receiver-operating-characteristic curves were determined. RESULTS Among 414 nodules on CT, 53.3% (221/414) were visible on DT. The main reason for not seeing a nodule on DT was small size (93.3%, ≤ 5 mm). DT revealed a substantial number of malignant nodules (84.1%, 143/170). The proportion of malignant nodules among visible nodules on DT was significantly higher (64.7%, 143/221) than that on CT (41.1%, 170/414) (p < 0.001). Area under the curve (AUC) values at the initial session were > 0.8, and the average detection rate for malignant nodules was 85% (210/246). The inter-session analysis of the AUC showed no significant differences among the readers, and the detection rate for malignant nodules did not differ across sessions. A slight improvement in reading times was observed. CONCLUSION Most malignant nodules > 5 mm were visible on DT. As nodule detection performance was high from the initial session, DT may be readily applicable for radiology residents and board-certified radiologists.
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Affiliation(s)
- Kyung Hee Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul 110-744, Korea
| | - Sang Min Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea
| | - Chang Min Park
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul 110-744, Korea
| | - Young Eun Bahn
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea
| | - Hyungjin Kim
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea
| | - Yong Sub Song
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea
| | - Eui Jin Hwang
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea
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A Technique for Lung Nodule Candidate Detection in CT Using Global Minimization Methods. LECTURE NOTES IN COMPUTER SCIENCE 2015. [DOI: 10.1007/978-3-319-14612-6_35] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Sayyouh M, Vummidi DR, Kazerooni EA. Evaluation and management of pulmonary nodules: state-of-the-art and future perspectives. ACTA ACUST UNITED AC 2014; 7:629-44. [PMID: 24175679 DOI: 10.1517/17530059.2013.858117] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The imaging evaluation of pulmonary nodules, often incidentally detected on imaging examinations performed for other clinical reasons, is a frequently encountered clinical circumstance. With advances in imaging modalities, both the detection and characterization of pulmonary nodules continue to evolve and improve. AREAS COVERED This article will review the imaging modalities used to detect and diagnose benign and malignant pulmonary nodules, with a focus on computed tomography (CT), which continues to be the mainstay for evaluation. The authors discuss recent advances in the lung nodule management, and an algorithm for the management of indeterminate pulmonary nodules. EXPERT OPINION There are set of criteria that define a benign nodule, the most important of which are the lack of temporal change for 2 years or more, and certain benign imaging criteria, including specific patterns of calcification or the presence of fat. Although some indeterminate pulmonary nodules are immediately actionable, generally those approaching 1 cm or larger in diameter, at which size the diagnostic accuracy of tools such as positron emission tomography (PET)/CT, single photon emission CT (SPECT) and biopsy techniques are sufficient to warrant their use. The majority of indeterminate pulmonary nodules are under 1 cm, for which serial CT examinations through at least 2 years for solid nodules and 3 years for ground-glass nodules, are used to demonstrate either benign biologic behavior or otherwise. The management of incidental pulmonary nodules involves a multidisciplinary approach in which radiology plays a pivotal role. Newer imaging and postprocessing techniques have made this a more accurate technique eliminating ambiguity and unnecessary follow-up.
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Affiliation(s)
- Mohamed Sayyouh
- University of Michigan Health System, Division of Cardiothoracic Radiology, Department of Radiology , Ann Arbor, MI , USA
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Bildnachverarbeitung Teil 1: Visualisierung und Segmentierung. Radiologe 2013; 53:805-9. [DOI: 10.1007/s00117-013-2513-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bogoni L, Ko JP, Alpert J, Anand V, Fantauzzi J, Florin CH, Koo CW, Mason D, Rom W, Shiau M, Salganicoff M, Naidich DP. Impact of a computer-aided detection (CAD) system integrated into a picture archiving and communication system (PACS) on reader sensitivity and efficiency for the detection of lung nodules in thoracic CT exams. J Digit Imaging 2013; 25:771-81. [PMID: 22710985 DOI: 10.1007/s10278-012-9496-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The objective of this study is to assess the impact on nodule detection and efficiency using a computer-aided detection (CAD) device seamlessly integrated into a commercially available picture archiving and communication system (PACS). Forty-eight consecutive low-dose thoracic computed tomography studies were retrospectively included from an ongoing multi-institutional screening study. CAD results were sent to PACS as a separate image series for each study. Five fellowship-trained thoracic radiologists interpreted each case first on contiguous 5 mm sections, then evaluated the CAD output series (with CAD marks on corresponding axial sections). The standard of reference was based on three-reader agreement with expert adjudication. The time to interpret CAD marking was automatically recorded. A total of 134 true-positive nodules, measuring 3 mm and larger were included in our study; with 85 ≥ 4 and 50 ≥ 5 mm in size. Readers detection improved significantly in each size category when using CAD, respectively, from 44 to 57 % for ≥3 mm, 48 to 61 % for ≥4 mm, and 44 to 60 % for ≥5 mm. CAD stand-alone sensitivity was 65, 68, and 66 % for nodules ≥3, ≥4, and ≥5 mm, respectively, with CAD significantly increasing the false positives for two readers only. The average time to interpret and annotate a CAD mark was 15.1 s, after localizing it in the original image series. The integration of CAD into PACS increases reader sensitivity with minimal impact on interpretation time and supports such implementation into daily clinical practice.
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Hodnett PA, Ko JP. Evaluation and Management of Indeterminate Pulmonary Nodules. Radiol Clin North Am 2012; 50:895-914. [DOI: 10.1016/j.rcl.2012.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Jeon KN, Goo JM, Lee CH, Lee Y, Choo JY, Lee NK, Shim MS, Lee IS, Kim KG, Gierada DS, Bae KT. Computer-aided nodule detection and volumetry to reduce variability between radiologists in the interpretation of lung nodules at low-dose screening computed tomography. Invest Radiol 2012; 47:457-61. [PMID: 22717879 PMCID: PMC3501405 DOI: 10.1097/rli.0b013e318250a5aa] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate whether a computer-aided diagnosis (CAD) system improves interobserver agreement in the interpretation of lung nodules at low-dose computed tomography (CT) screening for lung cancer. MATERIALS AND METHODS Baseline low-dose screening CT examinations from 134 participants enrolled in the National Lung Screening Trial were reviewed by 7 chest radiologists. All participants consented to the use of their deidentified images for research purposes. Screening results were classified as positive when noncalcified nodules larger than 4 mm in diameter were present. Follow-up evaluation was recommended according to the nodule diameter: 4 mm or smaller, more than 4 to 8 mm, and larger than 8 mm. When multiple nodules were present, recommendations were based on the largest nodule. Readers initially assessed the nodule presence visually and measured the average nodule diameter manually. Revision of their decisions after reviewing the CAD marks and size measurement was allowed. Interobserver agreement evaluated using multirater κ statistics was compared between initial assessment and that with CAD. RESULTS Multirater κ values for the positivity of the screening results and follow-up recommendations were improved from moderate (κ = 0.53-0.54) at initial assessment to good (κ = 0.66-0.67) after reviewing CAD results. The average percentage of agreement between reader pairs on the positivity of screening results and follow-up recommendations per case was also increased from 77% and 72% at initial assessment to 84% and 80% with CAD, respectively. CONCLUSION Computer-aided diagnosis may improve the reader agreement on the positivity of screening results and follow-up recommendations in the assessment of low-dose screening CT.
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Affiliation(s)
- Kyung Nyeo Jeon
- Department of Diagnostic Radiology, College of Medicine, Gyeongsang National University, Jinju, Korea
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Hyun Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Youkyung Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Ji Yung Choo
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Nyoung Keun Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Mi-Suk Shim
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - In Sun Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Kwang Gi Kim
- Biomedical Engineering Branch, Division of Convergence Technology, National Cancer Center, Gyeonggi-Do, Korea
| | - David S. Gierada
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO
| | - Kyongtae T. Bae
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Goo JM. A computer-aided diagnosis for evaluating lung nodules on chest CT: the current status and perspective. Korean J Radiol 2011; 12:145-55. [PMID: 21430930 PMCID: PMC3052604 DOI: 10.3348/kjr.2011.12.2.145] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 09/16/2010] [Indexed: 12/03/2022] Open
Abstract
As the detection and characterization of lung nodules are of paramount importance in thoracic radiology, various tools for making a computer-aided diagnosis (CAD) have been developed to improve the diagnostic performance of radiologists in clinical practice. Numerous studies over the years have shown that the CAD system can effectively help readers identify more nodules. Moreover, nodule malignancy and the response of malignant lung tumors to treatment can also be assessed using nodule volumetry. CAD also has the potential to objectively analyze the morphology of nodules and enhance the workflow during the assessment of follow-up studies. Therefore, understanding the current status and limitations of CAD for evaluating lung nodules is essential to effectively apply CAD in clinical practice.
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Affiliation(s)
- Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine and the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea.
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