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Wang D, Li P, Fei X, Che S, Li J, Xuan Y, Wang J, Han Y, Gu W, Wang Y. A combined diagnostic model based on circulating tumor cell in patients with solitary pulmonary nodules. J Gene Med 2023; 25:e3529. [PMID: 37194408 DOI: 10.1002/jgm.3529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/20/2023] [Accepted: 05/01/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Although many prediction models in diagnosis of solitary pulmonary nodules (SPNs) have been developed, few are widely used in clinical practice. It is therefore imperative to identify novel biomarkers and prediction models supporting early diagnosis of SPNs. This study combined folate receptor-positive circulating tumor cells (FR+ CTC) with serum tumor biomarkers, patient demographics and clinical characteristics to develop a prediction model. METHODS A total of 898 patients with a solitary pulmonary nodule who received FR+ CTC detection were randomly assigned to a training set and a validation set in a 2:1 ratio. Multivariate logistic regression was used to establish a diagnostic model to differentiate malignant and benign nodules. The receiver operating curve (ROC) and the area under the curve (AUC) were calculated to assess the diagnostic efficiency of the model. RESULTS The positive rate of FR+ CTC between patients with non-small cell lung cancer (NSCLC) and benign lung disease was significantly different in both the training and the validation dataset (p < 0.001). The FR+ CTC level was significantly higher in the NSCLC group compared with that of the benign group (p < 0.001). FR+ CTC (odds ratio, OR, 95% confidence interval, CI: 1.13, 1.07-1.19, p < 0.0001), age (OR, 95% CI: 1.06, 1.01-1.12, p = 0.03) and sex (OR, 95% CI: 1.07, 1.01-1.13, p = 0.01) were independent risk factors of NSCLC in patients with a solitary pulmonary nodule. The area under the curve (AUC) of FR+ CTC in diagnosing NSCLC was 0.650 (95% CI, 0.587-0.713) in the training set and 0.700 (95% CI, 0.603-0.796) in the validation set, respectively. The AUC of the combined model was 0.725 (95% CI, 0.659-0.791) in the training set and 0.828 (95% CI, 0.754-0.902) in the validation set, respectively. CONCLUSIONS We confirmed the value of FR+ CTC in diagnosing SPNs and developed a prediction model based on FR+ CTC, demographic characteristics, and serum biomarkers for differential diagnosis of solitary pulmonary nodules.
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Affiliation(s)
- Dong Wang
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Peng Li
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiang Fei
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shuyu Che
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jinlong Li
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yunpeng Xuan
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jinglong Wang
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yudong Han
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Weiqing Gu
- Department of Oncology, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai, China
| | - Yongjie Wang
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
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Zhou Q, He Q, Peng L, Huang Y, Li K, Liu K, Li D, Zhao J, Sun K, Li A, He W. Preoperative diagnosis of solitary pulmonary nodules with a novel hematological index model based on circulating tumor cells. Front Oncol 2023; 13:1150539. [PMID: 37207165 PMCID: PMC10189144 DOI: 10.3389/fonc.2023.1150539] [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: 01/24/2023] [Accepted: 04/19/2023] [Indexed: 05/21/2023] Open
Abstract
Objective Preoperative noninvasive diagnosis of the benign or malignant solitary pulmonary nodule (SPN) is still important and difficult for clinical decisions and treatment. This study aimed to assist in the preoperative diagnosis of benign or malignant SPN using blood biomarkers. Methods A total of 286 patients were recruited for this study. The serum FR+CTC, TK1, TP, TPS, ALB, Pre-ALB, ProGRP, CYFRA21-1, NSE, CA50, CA199, and CA242 were detected and analyzed. Results In the univariate analysis, age, FR+CTC, TK1, CA50, CA19.9, CA242, ProGRP, NSE, CYFRA21-1, and TPS showed the statistical significance of a correlation with malignant SPNs (P <0.05). The highest performing biomarker is FR+CTC (odd ratio [OR], 4.47; 95% CI: 2.57-7.89; P <0.001). The multivariate analysis identified that age (OR, 2.69; 95% CI: 1.34-5.59, P = 0.006), FR+CTC (OR, 6.26; 95% CI: 3.09-13.37, P <0.001), TK1 (OR, 4.82; 95% CI: 2.4-10.27, P <0.001), and NSE (OR, 2.06; 95% CI: 1.07-4.06, P = 0.033) are independent predictors. A prediction model based on age, FR+CTC, TK1, CA50, CA242, ProGRP, NSE, and TPS was developed and presented as a nomogram, with a sensitivity of 71.1% and a specificity of 81.3%, and the AUC was 0.826 (95% CI: 0.768-0.884). Conclusions The novel prediction model based on FR+CTC showed much stronger performance than any single biomarker, and it can assist in predicting benign or malignant SPNs.
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Affiliation(s)
- Qiuxi Zhou
- Department of General Internal Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, China
| | - Qiao He
- Department of Clinical Laboratory, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, China
| | - Ling Peng
- Department of General Internal Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, China
| | - Yecai Huang
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, China
| | - Kexun Li
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, China
| | - Kun Liu
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, China
| | - Da Li
- Department of General Internal Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, China
| | - Jing Zhao
- Department of General Internal Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, China
| | - Kairong Sun
- Department of Respiratory Medicine, Sichuan Academy Medical Sciences, Sichuan Provincial People’s Hospital, Chengdu, China
| | - Aoshuang Li
- Department of Gastroenterology, Chengdu Third People’s Hospital, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Wenwu He
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Cancer Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, China
- *Correspondence: Wenwu He,
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Zhu YQ, Liu C, Mo Y, Dong H, Huang C, Duan YN, Tang LL, Chu YY, Qin J. Radiomics for differentiating minimally invasive adenocarcinoma from precursor lesions in pure ground-glass opacities on chest computed tomography. Br J Radiol 2022; 95:20210768. [PMID: 35262392 PMCID: PMC10996418 DOI: 10.1259/bjr.20210768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 02/27/2022] [Accepted: 03/04/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To explore the correlation between radiomic features and the pathology of pure ground-glass opacities (pGGOs), we established a radiomics model for predicting the pathological subtypes of minimally invasive adenocarcinoma (MIA) and precursor lesions. METHODS CT images of 1521 patients with lung adenocarcinoma or precursor lesions appearing as pGGOs on CT in our hospital (The Third Affiliated Hospital of Sun Yat-sen University) from January 2015 to March 2021 were analyzed retrospectively and selected based on inclusion and exclusion criteria. pGGOs were divided into an atypical adenomatous hyperplasia (AAH)/adenocarcinoma in situ (AIS) group and an MIA group. Radiomic features were extracted from the original and preprocessed images of the region of interest. ANOVA and least absolute shrinkage and selection operator feature selection algorithm were used for feature selection. Logistic regression algorithm was used to construct radiomics prediction model. Receiver operating characteristic curves were used to evaluate the classification efficiency. RESULTS 129 pGGOs were included. 2107 radiomic features were extracted from each region of interest. 18 radiomic features were eventually selected for model construction. The area under the curve of the radiomics model was 0.884 [95% confidence interval (CI), 0.818-0.949] in the training set and 0.872 (95% CI, 0.756-0.988) in the test set, with a sensitivity of 72.73%, specificity of 88.24% and accuracy of 79.47%. The decision curve indicated that the model had a high net benefit rate. CONCLUSION The prediction model for pathological subtypes of MIA and precursor lesions in pGGOs demonstrated a high diagnostic accuracy. ADVANCES IN KNOWLEDGE We focused on lesions appearing as pGGOs on CT and revealed the differences in radiomic features between MIA and precursor lesions. We constructed a radiomics prediction model and improved the diagnostic accuracy for the pathology of MIA and precursor lesions.
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Affiliation(s)
- Yan-qiu Zhu
- Department of Radiology, The Third Affiliated Hospital of Sun
Yat-sen University, No. 600 Tianhe Road, Tianhe District,
Guangzhou, China
| | - Chaohui Liu
- Department of Research Collaboration, R&D Center, Beijing
Deepwise & League of PHD Technology Co. Ltd,
Beijing, China
| | - Yan Mo
- Department of Research Collaboration, R&D Center, Beijing
Deepwise & League of PHD Technology Co. Ltd,
Beijing, China
| | - Hao Dong
- Department of Research Collaboration, R&D Center, Beijing
Deepwise & League of PHD Technology Co. Ltd,
Beijing, China
| | - Chencui Huang
- Department of Research Collaboration, R&D Center, Beijing
Deepwise & League of PHD Technology Co. Ltd,
Beijing, China
| | - Ya-ni Duan
- Department of Radiology, The Third Affiliated Hospital of Sun
Yat-sen University, No. 600 Tianhe Road, Tianhe District,
Guangzhou, China
| | - Lei-lei Tang
- Department of Radiology, The Third Affiliated Hospital of Sun
Yat-sen University, No. 600 Tianhe Road, Tianhe District,
Guangzhou, China
| | - Yuan-yuan Chu
- Department of Radiology, The Third Affiliated Hospital of Sun
Yat-sen University, No. 600 Tianhe Road, Tianhe District,
Guangzhou, China
| | - Jie Qin
- Department of Radiology, The Third Affiliated Hospital of Sun
Yat-sen University, No. 600 Tianhe Road, Tianhe District,
Guangzhou, China
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Multivariate Analysis on Development of Lung Adenocarcinoma Lesion from Solitary Pulmonary Nodule. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:8330111. [PMID: 35795880 PMCID: PMC9155859 DOI: 10.1155/2022/8330111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/14/2022] [Accepted: 04/27/2022] [Indexed: 12/01/2022]
Abstract
Objective To analyze multiple factors developing lung adenocarcinoma lesion from solitary pulmonary nodule (SPN). Methods A total of 70 patients diagnosed with lung adenocarcinoma after finding SPN by chest CT and treated in our hospital (01, 2018–01, 2021) were selected as the malignant lesion group, and another 70 patients diagnosed with benign lesion after finding SPN by CT in the same period were included in the benign lesion group. All patients had complete medical records. With univariate analysis and multivariate logistic regression, the independent risk factors for developing lung adenocarcinoma lesions from SPN were analyzed. Results By conducting univariate analysis of patients' general information (age, course of disease, BMI, nodule diameter, and gender), smoking status (smoking history and number of cigarettes smoked per year), medical history (family history of lung cancer, history of extrapulmonary malignant tumor, and history of autoimmune diseases), basic complications (hypertension and diabetes), and laboratory examinations (CEA, NSE, CYFRA21-1, SCC-Ag, and CA125), it was concluded that age, course of disease, nodule diameter, CEA positive, CYFRA21-1 positive, and CA125 positive were significantly different between the two groups (P < 0.05); the logistic regression results showed that high age, increased nodule diameter, and CYFRA21-1 positive were the independent risk factors developing lung adenocarcinoma from SPN (P < 0.05). Conclusion In patients with SPN, higher age, longer course of disease, greater nodule diameter, and CYFRA21-1 positive imply increased risk for triggering lung adenocarcinoma lesion. Therefore, high attention should be paid in the clinic to such SPN patients for early diagnosis and treatment.
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Hou D, Cui T. Re: A radiomics study to predict invasive pulmonary adenocarcinoma appearing as pure ground-glass nodules. Clin Radiol 2021; 77:236-237. [PMID: 34969519 DOI: 10.1016/j.crad.2021.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/20/2021] [Indexed: 11/03/2022]
Affiliation(s)
- D Hou
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - T Cui
- Liao Ning Tumour Hospital, Shenyang, China.
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Reponen J, Niinimäki J. Emergence of teleradiology, PACS, and other radiology IT solutions in Acta Radiologica. Acta Radiol 2021; 62:1525-1533. [PMID: 34637341 DOI: 10.1177/02841851211051003] [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] [Indexed: 11/15/2022]
Abstract
For this historical review, we searched a database containing all the articles published in Acta Radiologica during its 100-year history to find those on the use of information technology (IT) in radiology. After reading the full texts, we selected the presented articles according to major radiology IT domains such as teleradiology, picture archiving and communication systems, image processing, image analysis, and computer-aided diagnostics in order to describe the development as it appeared in the journal. Publications generally follow IT megatrends, but because the contents of Acta Radiologica are mainly clinically oriented, some technology achievements appear later than they do in journals discussing mainly imaging informatics topics.
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Affiliation(s)
- Jarmo Reponen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jaakko Niinimäki
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
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Shi L, Zhao J, Peng X, Wang Y, Liu L, Sheng M. CT-based radiomics for differentiating invasive adenocarcinomas from indolent lung adenocarcinomas appearing as ground-glass nodules: Asystematic review. Eur J Radiol 2021; 144:109956. [PMID: 34563797 DOI: 10.1016/j.ejrad.2021.109956] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/25/2021] [Accepted: 08/28/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To provide an overview of the available studies investigating the use of computer tomography (CT) radiomics features for differentiating invasive adenocarcinomas (IAC) from indolent lung adenocarcinomas presenting as ground-glass nodules (GGNs), to identify the bias of the studies and to propose directions for future research. METHOD PubMed, Embase, Web of Science Core Collection were searched for relevant studies. The studies differentiating IAC from indolent lung adenocarcinomas appearing as GGNs based on CT radiomics features were included. Basic information, patient information, CT-scanner information, technique information and performance information were extracted for each included study. The quality of each study was assessed using the Radiomic Quality Score (RQS) and the Prediction model Risk of Bias Assessment Tool (PROBAST). RESULTS Twenty-eight studies were included with patients ranging from 34 to 794. All of them were retrospective. Patients in three studies were from multiple centers. Most studies segmented regions of interest manually. Pyradiomics and AK software were the most frequently used for features extraction. The number of radiomics features extracted varied from 7 to 10329. Logistic regression was the most frequently chosen model. Entropy was identified as radiomics signature in seven studies. The AUC of included studies ranged from 0.77 to 0.98 in 15 validation sets. The percentage RQS ranged from 3% to 50%. According to PROBAST, the overall risk of bias (ROB) was high in 89.3% (25/28) of included studies, unclear in 7.1% (2/28) of included studies, and low in 3.6% (1/28) of included studies. All studies were low concern regarding the applicability of primary studies to the review question. CONCLUSION CT radiomics-based model is promising and encouraging in differentiating IAC from indolent lung adenocarcinomas, though they require methodological rigor. Well-designed studies are necessary to demonstrate their validity and standardization of methods and results can prompt their use in daily clinical practice.
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Affiliation(s)
- Lili Shi
- Medical School, Nantong University, Nantong, China; Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Jinli Zhao
- Department of Radiology, Affiliated Hospital of Nantong University, Nantong, China
| | - Xueqing Peng
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Yunpeng Wang
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Lei Liu
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China; School of Basic Medical Sciences, and Academy of Engineering and Technology, Fudan University, Shanghai, China.
| | - Meihong Sheng
- Department of Radiology, The Second Affiliated Hospital of Nantong University and Nantong First People's Hospital, Nantong, China.
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Wu L, Gao C, Ye J, Tao J, Wang N, Pang P, Xiang P, Xu M. The value of various peritumoral radiomic features in differentiating the invasiveness of adenocarcinoma manifesting as ground-glass nodules. Eur Radiol 2021; 31:9030-9037. [PMID: 34037830 DOI: 10.1007/s00330-021-07948-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/25/2021] [Accepted: 03/25/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the ability of CT radiomic features extracted from peritumoral parenchyma of 2 mm and 5 mm distinguishing invasive adenocarcinoma (IAC) from adenocarcinoma in situ (AIS)/minimally invasive adenocarcinoma (MIA). METHODS For this retrospective study, 121 lung adenocarcinomas appearing as ground-glass nodules on thin-section CT were evaluated. Quantitative radiomic features were extracted from the peritumoral parenchymal region of 2 mm and 5 mm on CT imaging, and the radiomic models of External2 and External5 were constructed. The ROC curves were used to evaluate the performance of different models. Differences between the AUCs were evaluated using DeLong's method. RESULTS The radiomic scores of IAC were statistically higher than those of MIA/AIS in both the External2 and External5 models. The AUCs of the External2 and External5 models were 0.882, 0.778 in the training cohort and 0.888, 0.804 in the validation cohort, respectively. The AUC of the External2 model was not statistically different from the External5 model both in the training cohort (p = 0.116) and validation cohort (p = 0.423). CONCLUSIONS The radiomic features extracted from the peritumoral region of 2 mm and 5 mm at thin-section CT showed good predictive values to differentiate the IAC from AIS/MIA. The radiomic features from the peritumoral region of 5 mm provide no additional benefit in distinguishing IAC from MIA/AIS than that of the 2 mm region. KEY POINTS • The radiomic models from various peritumoral lung parenchyma were developed and validated to predict invasiveness of adenocarcinoma. • The peritumoral parenchyma of lung adenocarcinoma may contain useful information. • Radiomics from peritumoral lung parenchyma of 5 mm provides no added efficiency of the prediction for invasiveness of lung adenocarcinoma.
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Affiliation(s)
- Linyu Wu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Chen Gao
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Jianfeng Ye
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Jingying Tao
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Neng Wang
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Peipei Pang
- Department of Pharmaceuticals Diagnosis, GE Healthcare, Hangzhou, China
| | - Ping Xiang
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Maosheng Xu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China.
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China.
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Xiong Z, Jiang Y, Che S, Zhao W, Guo Y, Li G, Liu A, Li Z. Use of CT radiomics to differentiate minimally invasive adenocarcinomas and invasive adenocarcinomas presenting as pure ground-glass nodules larger than 10 mm. Eur J Radiol 2021; 141:109772. [PMID: 34022476 DOI: 10.1016/j.ejrad.2021.109772] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/12/2021] [Accepted: 05/10/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE This study aimed to develop a model based on radiomics features extracted from computed tomography (CT) images to effectively differentiate between minimally invasive adenocarcinomas (MIAs) and invasive adenocarcinomas (IAs) manifesting as pure ground-glass nodules (pGGNs) larger than 10 mm. METHOD This retrospective study included patients who underwent surgical resection for persistent pGGN between November 2012 and June 2018 and diagnosed with MIAs or IAs. The patients were randomly assigned to the training and test cohorts. The correlation coefficient method and the least absolute shrinkage and selection operator (LASSO) method were applied to select radiomics features useful for constructing a model whose performance was assessed by the area under the receiver operating characteristic curve (AUC-ROC). The radiomics model was compared to a standard CT model (shape, volume and mean CT value of the largest cross-section) and the combined radiomics-standard CT model using univariate and multivariate logistic regression analysis. RESULTS The radiomics model showed better discriminative ability (training AUC, 0.879; test AUC, 0.877) than the standard CT model (training AUC, 0.820; test AUC, 0.828). The combined model (training AUC, 0.879; test AUC, 0.870) did not demonstrate improved performance compared with the radiomics model. Radiomics_score was an independent predictor of invasiveness following multivariate logistic analysis. CONCLUSIONS For pGGNs larger than 10 mm, the radiomics model demonstrated superior diagnostic performance in differentiating between IAs and MIAs, which may be useful to clinicians for diagnosis and treatment selection.
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Affiliation(s)
- Ziqi Xiong
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China.
| | - Yining Jiang
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China.
| | - Siyu Che
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China.
| | - Wenjing Zhao
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China.
| | - Yan Guo
- GE Healthcare, Shenyang, China
| | - Guosheng Li
- Department of Pathology, the First Affiliated Hospital of Dalian Medical University, Dalian, China.
| | - Ailian Liu
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China.
| | - Zhiyong Li
- Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China.
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Yu Y, Wang N, Huang N, Liu X, Zheng Y, Fu Y, Li X, Wu H, Xu J, Cheng J. Determining the invasiveness of ground-glass nodules using a 3D multi-task network. Eur Radiol 2021; 31:7162-7171. [PMID: 33665717 DOI: 10.1007/s00330-021-07794-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 12/17/2020] [Accepted: 02/15/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of this study was to determine the invasiveness of ground-glass nodules (GGNs) using a 3D multi-task deep learning network. METHODS We propose a novel architecture based on 3D multi-task learning to determine the invasiveness of GGNs. In total, 770 patients with 909 GGNs who underwent lung CT scans were enrolled. The patients were divided into the training (n = 626) and test sets (n = 144). In the test set, invasiveness was classified using deep learning into three categories: atypical adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive pulmonary adenocarcinoma (IA). Furthermore, binary classifications (AAH/AIS/MIA vs. IA) were made by two thoracic radiologists and compared with the deep learning results. RESULTS In the three-category classification task, the sensitivity, specificity, and accuracy were 65.41%, 82.21%, and 64.9%, respectively. In the binary classification task, the sensitivity, specificity, accuracy, and area under the ROC curve (AUC) values were 69.57%, 95.24%, 87.42%, and 0.89, respectively. In the visual assessment of GGN invasiveness of binary classification by the two thoracic radiologists, the sensitivity, specificity, and accuracy of the senior and junior radiologists were 58.93%, 90.51%, and 81.35% and 76.79%, 55.47%, and 61.66%, respectively. CONCLUSIONS The proposed multi-task deep learning model achieved good classification results in determining the invasiveness of GGNs. This model may help to select patients with invasive lesions who need surgery and the proper surgical methods. KEY POINTS • The proposed multi-task model has achieved good classification results for the invasiveness of GGNs. • The proposed network includes a classification and segmentation branch to learn global and regional features, respectively. • The multi-task model could assist doctors in selecting patients with invasive lesions who need surgery and choosing appropriate surgical methods.
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Affiliation(s)
- Ye Yu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Na Wang
- SenseTime Research, Shanghai, 200233, China
| | - Ning Huang
- SenseTime Research, Shanghai, 200233, China
| | | | - Yuanjie Zheng
- School of Information Science and Engineering at Shandong Normal University, Jinan, 250358, China
| | - Yicheng Fu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Xiaoqian Li
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Huawei Wu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Jianrong Xu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China.
| | - Jiejun Cheng
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China.
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A radiomics study to predict invasive pulmonary adenocarcinoma appearing as pure ground-glass nodules. Clin Radiol 2020; 76:143-151. [PMID: 33187676 DOI: 10.1016/j.crad.2020.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/08/2020] [Indexed: 12/17/2022]
Abstract
AIM To establish a machine-learning model to differentiate adenocarcinoma in situ (AIS) or minimally invasive adenocarcinoma (MIA) from invasive adenocarcinoma (IAC) appearing as pure ground-glass nodules (pGGNs). MATERIALS AND METHODS This retrospective study enrolled 136 patients with histopathologically diagnosed with AIS, MIA, and IAC. All pGGNs were divided randomly into a training and a testing dataset at a ratio of 7 : 3. Radiomics features were extracted based on the unenhanced computed tomography (CT) images derived from the last preoperative CT examination of each patient. The F-test and least absolute shrinkage and selection operator (LASSO) logistic regression were applied to select the most valuable features to establish a support vector machine (SVM) model. The performance of the model was evaluated using the area under the receiver operating characteristic curve (AUROC), and the accuracy, sensitivity, and specificity were calculated to compare the diagnostic performance of radiologists and the SVM model. RESULTS Six significant radiomics features were selected to develop the SVM model and showed excellent ability to differentiate AIS/MIA from IAC in both the training dataset (AUROC=0.950, 95% confidence interval [CI]: 0.886-0.984) and the testing dataset (AUROC=0.945, 95% CI: 0.826-0.992). Compared with two radiologists, the proposed model possessed significant advantages with higher accuracy (90.24% versus 75.61% and 80.49%), sensitivity (91.67% versus 50% and 75%), and specificity (89.66% versus 86.21% and 82.76%). CONCLUSION A machine-learning model based on radiomics features exhibits superior diagnostic performance in differentiating AIS/MIA from IAC appearing as pGGNs.
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Hu D, Zhen T, Ruan M, Wu L. The value of percentile base on computed tomography histogram in differentiating the invasiveness of adenocarcinoma appearing as pure ground-glass nodules. Medicine (Baltimore) 2020; 99:e23114. [PMID: 33157987 PMCID: PMC7647573 DOI: 10.1097/md.0000000000023114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
To investigate the value of percentile base on computed tomography (CT) histogram analysis for distinguishing invasive adenocarcinoma (IA) from adenocarcinoma in situ (AIS) or micro invasive adenocarcinoma (MIA) appearing as pure ground-glass nodules.A total of 42 cases of pure ground-glass nodules that were surgically resected and pathologically confirmed as lung adenocarcinoma between January 2015 and May 2019 were included. Cases were divided into IA and AIS/MIA in the study. The percentile on CT histogram was compared between the 2 groups. Univariate and multivariate logistic regression were used to determine which factors demonstrated a significant effect on invasiveness. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) was used to evaluate the predictive ability of individual characteristics and the combined model.The 4 histogram parameters (25th percentile, 55th percentile, 95th percentile, 97.5th percentile) and the combined model all showed a certain diagnostic value. The combined model demonstrated the best diagnostic performance. The AUC values were as follows: 25th percentile = 0.693, 55th percentile = 0.706, 95th percentile = 0.713, 97.5th percentile = 0.710, and combined model = 0.837 (all P < .05).The percentile of histogram parameters help to improve the ability to radiologically determine the invasiveness of lung adenocarcinoma appearing as pure ground-glass nodules.
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Affiliation(s)
- Dacheng Hu
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine
| | - Tao Zhen
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine
| | - Mei Ruan
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine
| | - Linyu Wu
- Department of Radiology, the First Affiliated Hospital of Zhejiang Chinese Medical University
- The First Clinical Medical College of Zhejiang Chinese Medical University, Zhejiang, Hangzhou, China
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MRI radiomics-based nomogram for individualised prediction of synchronous distant metastasis in patients with clear cell renal cell carcinoma. Eur Radiol 2020; 31:1029-1042. [PMID: 32856163 DOI: 10.1007/s00330-020-07184-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/30/2020] [Accepted: 08/12/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the performance of a multiparametric MRI radiomics-based nomogram for the individualised prediction of synchronous distant metastasis (SDM) in patients with clear cell renal cell carcinoma (ccRCC). METHODS Two-hundred and one patients (training cohort: n = 126; internal validation cohort: n = 39; external validation cohort: n = 36) with ccRCC were retrospectively enrolled between January 2013 and June 2019. In the training cohort, the optimal MRI radiomics features were selected and combined to calculate the radiomics score (Rad-score). Incorporating Rad-score and SDM-related clinicoradiologic characteristics, the radiomics-based nomogram was established by multivariable logistic regression analysis, then the performance of the nomogram (discrimination and clinical usefulness) was evaluated and validated subsequently. Moreover, the prediction efficacy for SDM in ccRCC subgroups of different sizes was also assessed. RESULTS Incorporating Rad-score derived from 9 optimal MR radiomics features (age, pseudocapsule and regional lymph node), the radiomics-based nomogram was capable of predicting SDM in the training cohort (area under the ROC curve (AUC) = 0.914) and validated in both the internal and external cohorts (AUC = 0.854 and 0.816, respectively) and also showed a convincing predictive power in ccRCC subgroups of different sizes (≤ 4 cm, AUC = 0.875; 4-7 cm, AUC = 0.891; 7-10 cm, 0.908; > 10 cm, AUC = 0.881). Decision curve analysis indicated that the radiomics-based nomogram is of clinical usefulness. CONCLUSIONS The multiparametric MRI radiomics-based nomogram could achieve precise individualised prediction of SDM in patients with ccRCC, potentially improving the management of ccRCC. KEY POINTS • Radiomics features derived from multiparametric magnetic resonance images showed relevant association with synchronous distant metastasis in clear cell renal cell carcinoma. • MRI radiomics-based nomogram may serve as a potential tool for the risk prediction of synchronous distant metastasis in clear cell renal cell carcinoma.
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Yang G, Nie P, Zhao L, Guo J, Xue W, Yan L, Cui J, Wang Z. 2D and 3D texture analysis to predict lymphovascular invasion in lung adenocarcinoma. Eur J Radiol 2020; 129:109111. [PMID: 32559593 DOI: 10.1016/j.ejrad.2020.109111] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/24/2020] [Accepted: 05/31/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Lymphovascular invasion (LVI) impairs surgical outcomes in lung adenocarcinoma (LAC) patients. Preoperative prediction of LVI is challenging by using traditional clinical and imaging factors. The purpose of this study was to evaluate the value of two-dimensional (2D) and three-dimensional (3D) CT texture analysis (CTTA) in predicting LVI in LAC. METHODS A total of 149 LAC patients (50 LVI-present LACs and 99 LVI-absent LACs) were retrospectively enrolled. Clinical data and CT findings were analyzed to select independent clinical predictors. Texture features were extracted from 2D and 3D regions of interest (ROI) in 1.25 mm slice CT images. The 2D and 3D CTTA signatures were constructed with the least absolute shrinkage and selection operator algorithm and texture scores were calculated. The optimized CTTA signature was selected by comparing the predicting efficacy and clinical usefulness of 2D and 3D CTTA signatures. A CTTA nomogram was developed by integrating the optimized CTTA signature and clinical predictors, and its calibration, discrimination and clinical usefulness were evaluated. RESULTS Maximum diametre and spiculation were independent clinical predictors. 1125 texture features were extracted from 2D and 3D ROIs and reduced to 11 features to build 2D and 3D CTTA signatures. There was significant difference (P < 0.001) in AUC (area under the curve) between 2D signature (AUC, 0.938) and 3D signature (AUC, 0.753) in the training set. There was no significant difference (P = 0.056) in AUC between 2D signature (AUC, 0.856) and 3D signature (AUC, 0.701) in the test set. Decision curve analysis showed the 2D signature outperformed the 3D signature in terms of clinical usefulness. The 2D CTTA nomogram (AUC, 0.938 and 0.861, in the training and test sets), which incorporated the 2D signature and clinical predictors, showed a similar discrimination capability (P = 1.000 and 0.430, in the training and test sets) and clinical usefulness as the 2D signature, and outperformed the clinical model (AUC, 0.678 and 0.776, in the training and test sets). CONCLUSIONS 2D CTTA signature performs better than 3D CTTA signature. The 2D CTTA nomogram with the 2D signature and clinical predictors incorporated provides the similar performance as the 2D signature for individual LVI prediction in LAC.
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Affiliation(s)
- Guangjie Yang
- Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Pei Nie
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Lianzi Zhao
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Jian Guo
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wei Xue
- Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Lei Yan
- Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jingjing Cui
- Huiying Medical Technology Co. Ltd, Beijing, China
| | - Zhenguang Wang
- Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
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Wu L, Gao C, Xiang P, Zheng S, Pang P, Xu M. CT-Imaging Based Analysis of Invasive Lung Adenocarcinoma Presenting as Ground Glass Nodules Using Peri- and Intra-nodular Radiomic Features. Front Oncol 2020; 10:838. [PMID: 32537436 PMCID: PMC7267037 DOI: 10.3389/fonc.2020.00838] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/28/2020] [Indexed: 12/19/2022] Open
Abstract
Objective: To evaluate whether radiomic features extracted from intra and peri-nodular lesions can enhance the ability to differentiate between invasive adenocarcinoma (IA), minimally invasive adenocarcinoma (MIA), and adenocarcinoma in situ (AIS) manifesting as ground-glass nodule (GGN). Materials and Methods: This retrospective study enrolled 120 patients with a total of 121 pathologically confirmed lung adenocarcinomas (85 IA and 36 AIS/MIA) from January 2015 to May 2019. The recruited patients were randomly divided into training (84 nodules) and validation sets (37 nodules), with a ratio of 7:3. The minority group in the training set was balanced by the synthetic minority over-sampling (SMOTE) method. The intra-, peri-nodular, and gross region of interests (ROI) were delineated with manual annotation. Image features were quantitatively extracted from each ROI on CT images. The minimum redundancy maximum relevance (mRMR) feature ranking method and the least absolute shrinkage and selection operator (LASSO) classifier were used to eliminate unnecessary features. The intra- and peri-nodular radiomic features were combined to produce the gross radiomic signature. A combined clinical-radiomic model was constructed by multivariable logistic regression analysis. The predicted performances of different models were evaluated using receiver operating curve (ROC) and calibration curve. Results: The gross radiomic signature (AUC: training set = 0.896; validation set = 0.876) showed a good ability to discriminate the invasiveness of adenocarcinoma, comparing to intra-nodular (AUC: training set = 0.862; validation set = 0.852) or peri-nodular radiomic signature (AUC: training set = 0.825; validation set = 0.820). The AUC of the combined clinical-radiomic model was 0.917 for the training and 0.876 for the validation cohort, respectively. Conclusions: The gross radiomic signature of intra- and peri-nodular regions improved the prediction ability and aided predicting the invasiveness of lung adenocarcinoma appearing as GGN.
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Affiliation(s)
- Linyu Wu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, China.,Department of Radiology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Chen Gao
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, China.,Department of Radiology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Ping Xiang
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, China.,Department of Radiology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Sisi Zheng
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, China.,Department of Radiology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Peipei Pang
- Department of Pharmaceuticals Diagnosis, GE Healthcare, Hangzhou, China
| | - Maosheng Xu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, China.,Department of Radiology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
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