European Journal of Radiology最新文献_第4页

Gender gap among authorships of artificial intelligence articles in breast imaging 乳腺成像人工智能文章作者的性别差距

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-08-22 DOI: 10.1016/j.ejrad.2024.111691

引用次数: 0

The predictive value of coronary computed tomography angiography-derived fractional flow reserve for perioperative cardiac events in lung cancer surgery 冠状动脉计算机断层扫描血管造影得出的分数血流储备对肺癌手术围术期心脏事件的预测价值。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-08-22 DOI: 10.1016/j.ejrad.2024.111688

Purpose

As a non-invasive coronary functional examination, coronary computed tomography angiography (CCTA)-derived fractional flow reserve (CT-FFR) showed predictive value in several non-cardiac surgeries. This study aimed to evaluate the predictive value of CT-FFR in lung cancer surgery.

Method

We retrospectively collected 227 patients from January 2017 to June 2022 and used machine learning-based CT-FFR to evaluate the stable coronary artery disease (CAD) patients undergoing lung cancer surgery. The major adverse cardiac event (MACE) was defined as perioperative myocardial injury (PMI), myocardial infarction, heart failure, atrial and ventricular arrhythmia with hemodynamic disorder, cardiogenic shock and cardiac death. The multivariate logistic regression analysis was performed to identify risk factors for MACE and PMI. The discriminative capacity, goodness-of-fit, and reclassification improvement of prediction model were determined before and after the addition of CT-FFR≤0.8.

Results

The incidence of MACE was 20.7 % and PMI was 15.9 %. CT-FFR significantly outperformed CCTA in terms of accuracy for predicting MACE (0.737 vs 0.524). In the multivariate regression analysis, CT-FFR≤0.8 was an independent risk factor for both MACE [OR=10.77 (4.637, 25.016), P<0.001] and PMI [OR=8.255 (3.372, 20.207), P<0.001]. Additionally, we found that the performance of prediction model for both MACE and PMI improved after the addition of CT-FFR.

Conclusions

CT-FFR can be used to assess the risk of perioperative MACE and PMI in patients with stable CAD undergoing lung cancer surgery. It adds prognostic information in the cardiac evaluation of patients undergoing lung cancer surgery.

目的：作为一种无创冠状动脉功能检查，冠状动脉计算机断层扫描血管造影（CCTA）得出的分数血流储备（CT-FFR）在几种非心脏手术中显示出预测价值。本研究旨在评估 CT-FFR 在肺癌手术中的预测价值：我们回顾性收集了 2017 年 1 月至 2022 年 6 月期间的 227 例患者，并使用基于机器学习的 CT-FFR 对接受肺癌手术的稳定型冠状动脉疾病（CAD）患者进行评估。主要心脏不良事件（MACE）定义为围术期心肌损伤（PMI）、心肌梗死、心力衰竭、伴有血流动力学障碍的房性和室性心律失常、心源性休克和心源性死亡。通过多变量逻辑回归分析，确定了 MACE 和 PMI 的风险因素。结果表明，在添加 CT-FFR≤0.8 前后，预测模型的判别能力、拟合优度和重分类改善率均有所提高：MACE发生率为20.7%，PMI为15.9%。在预测 MACE 的准确性方面，CT-FFR 明显优于 CCTA（0.737 对 0.524）。在多变量回归分析中，CT-FFR≤0.8是MACE的独立危险因素[OR=10.77 (4.637, 25.016)，PC结论：CT-FFR可用于评估接受肺癌手术的稳定型CAD患者围术期MACE和PMI的风险。它为肺癌手术患者的心脏评估增加了预后信息。

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引用次数: 0

Adding contrast-enhanced ultrasound can improve the predictive ability of breast conventional ultrasound and mammography for pathological upgrade of biopsy-confirmed ductal carcinoma in situ 添加造影剂增强超声波可提高乳腺常规超声波和乳腺 X 线照相术对活检证实的导管原位癌病理升级的预测能力

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-08-20 DOI: 10.1016/j.ejrad.2024.111687

Objectives

To evaluate the added value of contrast-enhanced ultrasound (CEUS) on top of breast conventional imaging for predicting the upgrading of ductal carcinoma in situ (DCIS) to invasive cancer after surgery.

Methods

This retrospective study enrolled 140 biopsy-proven DCIS lesions in 138 patients and divided them into two groups based on postoperative histopathology: non-upgrade and upgrade groups. Conventional ultrasound (US), mammography (MMG), CEUS and clinicopathological (CL) features were reviewed and compared between the two groups. The predictive performance of different models (with and without CEUS features) for histologic upgrade were compared to calculate the added value of CEUS.

Results

Fifty-nine (42.1 %) lesions were histologically upgraded to invasive cancer after surgery. By logistic regression analyses, we found that high-grade DCIS at biopsy (P=0.004), ultrasonographic lesion size > 20 mm (P=0.007), mass-like lesion on US (P=0.030), the presence of suspicious calcification on MMG (P=0.014), the presence of perfusion defect (P=0.005) and the area under TIC>1021.34 ml (P<0.001) on CEUS were six independent factors predicting concomitant invasive components after surgery. The CL+US+MMG model made with the four predictors in the clinicopathologic, US and MMG categories yielded an area under the receiver operating curve (AUROC) value of 0.759 (95 % CI: 0.680–0.828) in predicting histological upgrade. The combination model built by adding the two CEUS predictors to the CL+US+MMG model showed higher predictive efficacy than the CL+US+MMG model (P=0.018), as the AUROC value was improved to 0.861 (95 % CI: 0.793–0.914).

Conclusions

The addition of contrast-enhanced ultrasound to breast conventional imaging could improve the preoperative prediction of an upgrade to invasive cancer from CNB −proven DCIS lesions.

目的评估对比增强超声（CEUS）在乳腺常规成像基础上预测乳腺导管原位癌（DCIS）术后升级为浸润性癌的附加值。方法这项回顾性研究纳入了 138 例患者中经活检证实的 140 例 DCIS 病变，并根据术后组织病理学将其分为两组：非升级组和升级组。研究人员对两组患者的常规超声（US）、乳腺X线摄影（MMG）、CEUS和临床病理（CL）特征进行了回顾和比较。比较了不同模型（有 CEUS 特征和无 CEUS 特征）对组织学升级的预测性能，以计算 CEUS 的附加值。通过逻辑回归分析，我们发现活检时的高分级 DCIS（P=0.004）、超声病灶大小 > 20 mm（P=0.007）、US 上的肿块样病灶（P=0.030）、MMG 上可疑钙化的存在（P=0.014）、存在灌注缺损（P=0.005）和CEUS的TIC下面积>1021.34 ml（P<0.001）是预测术后并发侵袭性成分的六个独立因素。利用临床病理学、US 和 MMG 类别中的四个预测因子建立的 CL+US+MMG 模型在预测组织学升级方面的接收者操作曲线下面积（AUROC）值为 0.759（95 % CI：0.680-0.828）。在CL+US+MMG模型中加入两个CEUS预测因子建立的组合模型比CL+US+MMG模型显示出更高的预测效力（P=0.018），因为AUROC值提高到了0.861（95 % CI：0.793-0.914）。

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引用次数: 0

Stickiness of 7 types of iodinated contrast media used during interventional radiology and interventional cardiology procedures 在介入放射学和介入心脏病学手术中使用的 7 种碘化造影剂的粘性

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-08-18 DOI: 10.1016/j.ejrad.2024.111645

Introduction

During Interventional Cardiology (IC) and Interventional Radiology (IR) procedures operators’ gloves, guide wires and catheters may stick together due to the inherent stickiness of Iodine Containing Contrast Media (ICCM). This may result in displacement of materials, compromising technical success. In this study we compare the stickiness of seven frequently used types of ICCM.

Material and methods

Xenetix 300, Hexabrix 320 (Guerbet, Villepinte, France), Ultravist 300 (Bayer, Leverkusen, Germany), Visipaque 270, Omnipaque 300, Visipaque 320 (GE, Wauwatosa, WI) and Iomeron300 (Bracco, Milano, Italy) are compared using a probe-tack test. Pieces of surgical gloves are put together with 0.1 ml of of ICCM in between, and subsequently pulled apart under computer control. Stickiness is measured as the work needed to separate the probes.

Results

From least to most sticky results were: Hexabrix 320 (mean Work (mJ); range: 0.70; 0.16–1.23), Visipaque 270 (1.18; 0.47–1.89), Visipaque 320 (1.70; 0.59–2.81), Iomeron 300 (3.01; 1.82–4.20), Xenetix 300 (5.83; 3.96–7.69), Ultravist 300 (5.83; 2.83–8.84), Omnipaque 300 (8.14; 6.95–9.33). The four least sticky ICCM differ statistically significantly (p = 0.000–0.004) from the remaining. In this research Omnipaque 300, Ultravist 300 and Xenetix 300 are the stickiest and may hence pose the greatest practical problems during procedures; in contrast, Hexabrix 320, Visipaque 270 and Visipaque 320 are the least sticky in this research and may therefore aid in constraining complications caused by stickiness.

Conclusion

A significant and reproducible difference in stickiness exists between commercially available ICCM, Hexabrix 320, Visipaque 270, Visipaque 320 and Iomeron 300, being least sticky.

导言在介入心脏病学 (IC) 和介入放射学 (IR) 手术过程中，由于含碘造影剂 (ICCM) 本身的粘性，操作人员的手套、导丝和导管可能会粘在一起。这可能会导致材料移位，影响技术成功。在本研究中，我们比较了七种常用含碘造影剂的粘性。材料和方法我们使用探针粘附试验比较了 Xenetix 300、Hexabrix 320（Guerbet，法国维勒班特）、Ultravist 300（拜耳，德国勒沃库森）、Visipaque 270、Omnipaque 300、Visipaque 320（GE，威斯康星州沃瓦托萨）和 Iomeron300（Bracco，意大利米兰）。将几片手术手套放在一起，中间夹 0.1 毫升 ICCM，然后在计算机控制下拉开。粘性以分开探针所需的工作量来衡量：Hexabrix 320（平均功（毫焦耳）；范围：0.70；0.16-1 毫焦耳）：0.70；0.16-1.23）、Visipaque 270（1.18；0.47-1.89）、Visipaque 320（1.70；0.59-2.81）、Iomeron 300（3.01；1.82-4.20）、Xenetix 300（5.83；3.96-7.69）、Ultravist 300（5.83；2.83-8.84）、Omnipaque 300（8.14；6.95-9.33）。四种粘性最小的 ICCM 与其他 ICCM 在统计学上有显著差异（p = 0.000-0.004）。在本研究中，Omnipaque 300、Ultravist 300 和 Xenetix 300 的粘性最大，因此可能会在手术过程中造成最大的实际问题；相比之下，Hexabrix 320、Visipaque 270 和 Visipaque 320 在本研究中的粘性最小，因此可能有助于减少粘性造成的并发症。

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引用次数: 0

Pancreatic necrosis volume is closely associated with late-onset vascular complications after discharge in necrotizing pancreatitis 胰腺坏死体积与坏死性胰腺炎出院后晚期血管并发症密切相关

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-08-18 DOI: 10.1016/j.ejrad.2024.111686

Purpose

To explore the incidence, dynamic changes, prognostic factors and prognosis of late-onset vascular complications after discharge in patients with necrotizing pancreatitis (NP), and determine the relationship between the pancreatic necrosis volume (PNV) and late-onset vascular complications.

Methods

This was a retrospective cohort study that included NP patients who did not have any vascular complications during index hospitalization. Computed tomography (CT) examinations were performed, and the PNV was calculated based on the picture archiving and communication system. Multivariate logistic regression analysis was employed to determine the potential prognostic factors for late-onset vascular complications after discharge.

Results

A total of 35.6 % (37/104) of the patients had late-onset portal venous system involvement during the one-year follow-up period, including 35 patients with stenosis and 2 patients with occlusion. No venous thrombosis or arterial vascular complications were observed. PNV > 134 cm³ (OR, 7.08, 95 % CI 1.83–27.36; P = 0.005) and pancreatic necrosis involving the body and/or tail of the pancreas (OR, 10.05; 95 % CI, 2.66–38.02; P = 0.001) were prognostic factors for abnormal patency of the portal venous system. The abnormal patency of the portal venous system tended to persist during follow-up, and gastric varices were observed in 32.4 % (12/37) of the patients in the abnormal patency group without any symptoms.

Conclusions

Late-onset vascular complications involving venous stenosis or occlusion were common in NP patients after discharge, approximately one third of whom developed gastric varices. PNV and the location of necrosis were closely associated with the development of these complications.

目的探讨坏死性胰腺炎（NP）患者出院后晚期血管并发症的发生率、动态变化、预后因素和预后，并确定胰腺坏死体积（PNV）与晚期血管并发症之间的关系。研究人员进行了计算机断层扫描（CT）检查，并根据图片存档和通信系统计算了PNV。结果在一年的随访期间，共有 35.6% （37/104）的患者晚期出现门静脉系统受累，其中包括 35 名狭窄患者和 2 名闭塞患者。未发现静脉血栓或动脉血管并发症。PNV > 134 cm3（OR，7.08；95 % CI，1.83-27.36；P = 0.005）和累及胰体和/或胰尾的胰腺坏死（OR，10.05；95 % CI，2.66-38.02；P = 0.001）是门静脉系统异常通畅的预后因素。门静脉系统的异常通畅往往在随访期间持续存在，在通畅异常组中，32.4%（12/37）的患者在没有任何症状的情况下观察到胃静脉曲张。结论NP 患者出院后出现静脉狭窄或闭塞的晚期血管并发症很常见，其中约三分之一的患者出现胃静脉曲张。PNV和坏死位置与这些并发症的发生密切相关。

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引用次数: 0

Ultrasound-guided minimally invasive cubital tunnel thread release: An experimental study 超声引导下的微创肘隧道螺纹松解术：一项实验研究。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-08-16 DOI: 10.1016/j.ejrad.2024.111682

Introduction

Cubital Tunnel Syndrome is characterized by the compression of the ulnar nerve in the cubital tunnel and can cause restrictions to the activities of daily living. Traditional treatment includes conservative methods and, in more severe cases, different types of surgery. In these cases, common side effects of surgery may limit the clinical success. A new alternative could be a minimally invasive Ultrasound-guided (US-guided) thread release of cubital tunnel retinaculum also known as the Osborne’s ligament. The aim of this study was to assess the efficacy and safety of ultrasound-guided thread cubital tunnel release (TCuTR) in an anatomical specimen model.

Methods

In this single-center prospective experimental study, US-guided thread cubital tunnel release (TCuTR) was performed on 11 softly embalmed anatomic specimens. Subsequently, the elbows were dissected to assess the transection of Osborne’s ligament and potential damage to adjacent structures.

Results

Due to calcification, one specimen was ineligible for the intervention. In all remaining ten interventions, Osborne’s ligament (OL) was completely transected, without any damage to the surrounding nerves, blood vessels, tendons, or muscles.

Conclusion

US-guided decompression has demonstrated a high success rate in transecting Osborne’s ligament while averting damage to neighboring structures. This emerging technique appears to present an efficient and secure alternative to existing procedures.

简介肘隧道综合征的特点是尺神经在肘隧道内受到压迫，会导致日常生活活动受到限制。传统的治疗方法包括保守疗法，在病情较为严重的情况下，还需要进行不同类型的手术。在这些病例中，手术的常见副作用可能会限制临床成功率。一种新的替代方法是在超声波引导下对肘管缰绳（又称奥斯本韧带）进行微创线松解术。本研究的目的是在解剖标本模型中评估超声引导下肘关节螺纹松解术（TCuTR）的有效性和安全性：在这项单中心前瞻性实验研究中，对11个软防腐解剖标本进行了超声引导下的螺纹肘隧道松解术（TCuTR）。随后，对肘部进行解剖，以评估奥斯本韧带的横断情况和对邻近结构的潜在损伤：结果：由于钙化，一个标本不符合介入条件。结果：由于钙化，一个标本不符合干预条件，其余十个干预标本中，奥斯本韧带（OL）被完全横断，周围神经、血管、肌腱或肌肉没有受到任何损伤：结论：US 导向减压术在横断奥斯本韧带方面取得了很高的成功率，同时避免了对邻近结构的损伤。这项新兴技术似乎为现有手术提供了一种高效、安全的替代方案。

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引用次数: 0

Development of a deep learning model for detecting lumbar vertebral fractures on CT images: An external validation 开发用于在 CT 图像上检测腰椎骨折的深度学习模型：外部验证

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-08-15 DOI: 10.1016/j.ejrad.2024.111685

Objective

To develop and externally validate a binary classification model for lumbar vertebral body fractures based on CT images using deep learning methods.

Methods

This study involved data collection from two hospitals for AI model training and external validation. In Cohort A from Hospital 1, CT images from 248 patients, comprising 1508 vertebrae, revealed that 20.9% had fractures (315 vertebrae) and 79.1% were non-fractured (1193 vertebrae). In Cohort B from Hospital 2, CT images from 148 patients, comprising 887 vertebrae, indicated that 14.8% had fractures (131 vertebrae) and 85.2% were non-fractured (756 vertebrae). The AI model for lumbar spine fractures underwent two stages: vertebral body segmentation and fracture classification. The first stage utilized a 3D V-Net convolutional deep neural network, which produced a 3D segmentation map. From this map, region of each vertebra body were extracted and then input into the second stage of the algorithm. The second stage employed a 3D ResNet convolutional deep neural network to classify each proposed region as positive (fractured) or negative (not fractured).

Results

The AI model’s accuracy for detecting vertebral fractures in Cohort A’s training set (n = 1199), validation set (n = 157), and test set (n = 152) was 100.0 %, 96.2 %, and 97.4 %, respectively. For Cohort B (n = 148), the accuracy was 96.3 %. The area under the receiver operating characteristic curve (AUC-ROC) values for the training, validation, and test sets of Cohort A, as well as Cohort B, and their 95 % confidence intervals (CIs) were as follows: 1.000 (1.000, 1.000), 0.978 (0.944, 1.000), 0.986 (0.969, 1.000), and 0.981 (0.970, 0.992). The area under the precision-recall curve (AUC-PR) values were 1.000 (0.996, 1.000), 0.964 (0.927, 0.985), 0.907 (0.924, 0.984), and 0.890 (0.846, 0.971), respectively. According to the DeLong test, there was no significant difference in the AUC-ROC values between the test set of Cohort A and Cohort B, both for the overall data and for each specific vertebral location (all P>0.05).

Conclusion

The developed model demonstrates promising diagnostic accuracy and applicability for detecting lumbar vertebral fractures.

方法本研究收集了两家医院的数据，用于人工智能模型的训练和外部验证。在第一医院的队列 A 中，来自 248 名患者的 1508 个椎体的 CT 图像显示，20.9% 的患者有骨折（315 个椎体），79.1% 的患者无骨折（1193 个椎体）。在第二医院的队列 B 中，148 名患者的 887 个椎体的 CT 图像显示，14.8% 的患者有骨折（131 个椎体），85.2% 的患者无骨折（756 个椎体）。腰椎骨折人工智能模型分为两个阶段：椎体分割和骨折分类。第一阶段利用三维 V-Net 卷积深度神经网络生成三维分割图。从该图中提取每个椎体的区域，然后输入算法的第二阶段。第二阶段采用三维 ResNet 卷积深度神经网络将每个建议区域分为阳性（骨折）或阴性（未骨折）。结果人工智能模型在队列 A 的训练集（n = 1199）、验证集（n = 157）和测试集（n = 152）中检测椎体骨折的准确率分别为 100.0%、96.2% 和 97.4%。队列 B（n = 148）的准确率为 96.3%。队列 A 和队列 B 的训练集、验证集和测试集的接收者操作特征曲线下面积（AUC-ROC）值及其 95% 置信区间（CIs）如下：1.000（1.000，1.000）、0.978（0.944，1.000）、0.986（0.969，1.000）和 0.981（0.970，0.992）。精确度-召回曲线下面积（AUC-PR）值分别为 1.000（0.996，1.000）、0.964（0.927，0.985）、0.907（0.924，0.984）和 0.890（0.846，0.971）。根据 DeLong 检验，队列 A 和队列 B 测试集的 AUC-ROC 值在整体数据和每个特定椎体位置上均无显着差异（均为 P>0.05）。

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引用次数: 0

Prospective study of dual-phase 99mTc-MIBI SPECT/CT nomogram for differentiating non-small cell lung cancer from benign pulmonary lesions 用于区分非小细胞肺癌和肺部良性病变的双相 99mTc-MIBI SPECT/CT 提名图前瞻性研究

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-08-15 DOI: 10.1016/j.ejrad.2024.111657

Objectives

To establish and validate a technetium ^99m sestamibi (^99mTc-MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT) nomogram for predicting non-small cell lung cancer (NSCLC). Comparing the diagnostic performance of early and delayed SPECT/CT nomogram, and compare the diagnostic performance of SPECT/CT radiomics models with single SPECT and CT radiomics models.

Methods

This prospective study included 119 lesions (NSCLC: n = 92, benign pulmonary lesions: n = 27) from 103 patients (mean age: 59.68 ± 8.94 years). Patients underwent dual-phase ^99mTc-MIBI SPECT/CT imaging. They were divided into the training (n = 83) and validation (n = 36) cohorts. Logistic regression, support vector machine, random forest, and light-gradient boosting machine were applied to train and determine the optimal machine learning model. Then, combining radiomics score and clinical factors, establish nomograms for diagnosing NSCLC.

Result

CYFRA21-1 was selected for constructing the clinical model. In early imaging, the areas under the curve (AUCs) of the clinical model, radiomics model, and nomogram were 0.571, 0.830, and 0.875, respectively. The nomogram performed better than the clinical model and similarly to the radiomics model (P=0.020, P=0.216), and there are no statistically significant differences in the predictive performance between the radiomics model and the clinical model (P=0.103). In delayed imaging, the AUC was 0.643, 0.888, and 0.893, respectively. The predictive performance of the nomogram was superior compared to the clinical model and comparable to the radiomics model (P=0.042, P=0.480), and the radiomics model also demonstrated superior diagnostic performance compared to the clinical model (P=0.049). Compared to early SPECT/CT results, the AUC values of the nomogram and radiomics models in the delayed phase were higher, although no statistical differences were found (P=0.831, P=0.568). In delayed imaging, the AUC of the radiomics models for CT and SPECT was 0.696 and 0.768, respectively, SPECT/CT radiomics exhibited significant differences compared with CT and SPECT alone (P=0.042, P=0.038).

Conclusion

Dual-phase ^99mTc-MIBI SPECT/CT nomograms and radiomics models can effectively predict NSCLC, providing an economically and non-invasive imaging method for diagnosing NSCLC, moreover, these findings provide a basis for early diagnosis and treatment strategies in NSCLC patients. Delayed-phase SPECT/CT imaging may offer greater practical value than early-phase imaging for diagnosing NSCLC. However, this novel approach necessitates further validation in larger, multi-center cohorts.

Clinical relevance

Radiomics nomogram based on SPECT/CT for discriminating NSCLC from benign lung l

目的建立并验证用于预测非小细胞肺癌（NSCLC）的锝99m sestamibi（99mTc-MIBI）单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）提名图。比较早期和延迟SPECT/CT提名图的诊断性能，并比较SPECT/CT放射组学模型与单一SPECT和CT放射组学模型的诊断性能。方法这项前瞻性研究纳入了103名患者（平均年龄：59.68 ± 8.94岁）的119个病灶（NSCLC：92个，肺部良性病灶：27个）。患者接受了双相 99mTc-MIBI SPECT/CT 成像检查。他们被分为训练组（n = 83）和验证组（n = 36）。应用逻辑回归、支持向量机、随机森林和光梯度提升机训练并确定最佳机器学习模型。然后，结合放射组学评分和临床因素，建立诊断 NSCLC 的提名图。在早期成像中，临床模型、放射组学模型和提名图的曲线下面积（AUC）分别为 0.571、0.830 和 0.875。提名图的表现优于临床模型，与放射组学模型相似（P=0.020，P=0.216），放射组学模型与临床模型的预测表现差异无统计学意义（P=0.103）。在延迟成像中，AUC 分别为 0.643、0.888 和 0.893。提名图的预测性能优于临床模型，与放射组学模型相当（P=0.042，P=0.480），放射组学模型的诊断性能也优于临床模型（P=0.049）。与早期SPECT/CT结果相比，延迟阶段的提名图和放射组学模型的AUC值更高，但未发现统计学差异（P=0.831，P=0.568）。在延迟成像中，CT 和 SPECT 放射组学模型的 AUC 分别为 0.696 和 0.768，SPECT/CT 放射组学与单独使用 CT 和 SPECT 相比有显著差异（P=0.042，P=0.038）。结论双相99m锝-MIBI SPECT/CT提名图和放射组学模型能有效预测NSCLC，为诊断NSCLC提供了一种经济、无创的成像方法，而且这些发现为NSCLC患者的早期诊断和治疗策略提供了依据。在诊断 NSCLC 方面，延迟期 SPECT/CT 成像可能比早期成像更具实用价值。临床意义基于SPECT/CT的放射组学提名图用于区分NSCLC和肺部良性病变，有助于帮助早期诊断和指导治疗。

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引用次数: 0

Large cell carcinoma of the lung: LDCT features and survival in screen-detected cases 肺大细胞癌：筛查出病例的 LDCT 特征和存活率

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-08-14 DOI: 10.1016/j.ejrad.2024.111679

Purpose

To investigate the early radiological features and survival of Large Cell Carcinoma (LCC) cases diagnosed in low-dose computed tomography (LDCT) screening trials.

Methods

Two radiologists jointly reviewed the radiological features of screen-detected LCCs observed in NLST, ITALUNG, and LUSI trials between 2002 and 2016, comprising a total of 29,744 subjects who underwent 3–5 annual screening LDCT examinations. Survival or causes of death were established according to the mortality registries extending more than 12 years since randomization.

Results

LCC was diagnosed in 30 (4 %) of 750 subjects with screen-detected lung cancer (LC), including 15 prevalent and 15 incident cases. Three additional LCCs occurred as interval cancers during the screening period. LDCT images were available for 29 cases of screen-detected LCCs, and 28 showed a single, peripheral, and well-defined solid nodule or mass with regularly smooth (39 %), lobulated (43 %), or spiculated (18 %) margins. One case presented as hilar mass. In 9 incident LCCs, smaller solid nodules were identified in prior LDCT examinations, allowing us to calculate a mean Volume Doubling Time (VDT) of 98.7 ± 47.8 days. The overall five-year survival rate was 50 %, with a significant (p = 0.0001) difference between stages I-II (75 % alive) and stages III-IV (10 % alive).

Conclusions

LCC is a fast-growing neoplasm that can escape detection by annual LDCT screening. LCC typically presents as a single solid peripheral nodule or mass, often with lobulated margins, and exhibits a short VDT. The 5-year survival reflects the stage at diagnosis.

目的研究在低剂量计算机断层扫描（LDCT）筛查试验中确诊的大细胞癌（LCC）病例的早期放射学特征和生存情况。方法两位放射科专家共同回顾了2002年至2016年期间在NLST、ITALUNG和LUSI试验中观察到的筛查出的LCC的放射学特征，共有29744名受试者接受了3-5次年度LDCT筛查。结果在筛查出肺癌（LC）的750名受试者中，有30人（4%）被确诊为LCC，其中包括15例首发病例和15例偶发病例。另有 3 例 LCC 在筛查期间作为间期癌症出现。有 29 例筛查出的 LCC 患者的 LDCT 图像，其中 28 例显示为单个、周边、轮廓清晰的实性结节或肿块，边缘规则光滑（39%）、分叶（43%）或呈棘状（18%）。其中一例表现为肺门肿块。在 9 例 LCC 患者中，先前的 LDCT 检查发现了较小的实性结节，因此我们计算出平均体积倍增时间（VDT）为 98.7 ± 47.8 天。总体五年生存率为 50%，I-II 期（75% 存活）和 III-IV 期（10% 存活）之间存在显著差异（p = 0.0001）。LCC通常表现为单个实性周围结节或肿块，边缘常呈分叶状，VDT较短。5年生存率反映了诊断时的分期。

{"title":"Large cell carcinoma of the lung: LDCT features and survival in screen-detected cases","authors":"","doi":"10.1016/j.ejrad.2024.111679","DOIUrl":"10.1016/j.ejrad.2024.111679","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the early radiological features and survival of Large Cell Carcinoma (LCC) cases diagnosed in low-dose computed tomography (LDCT) screening trials.</p></div><div><h3>Methods</h3><p>Two radiologists jointly reviewed the radiological features of screen-detected LCCs observed in NLST, ITALUNG, and LUSI trials between 2002 and 2016, comprising a total of 29,744 subjects who underwent 3–5 annual screening LDCT examinations. Survival or causes of death were established according to the mortality registries extending more than 12 years since randomization.</p></div><div><h3>Results</h3><p>LCC was diagnosed in 30 (4 %) of 750 subjects with screen-detected lung cancer (LC), including 15 prevalent and 15 incident cases. Three additional LCCs occurred as interval cancers during the screening period. LDCT images were available for 29 cases of screen-detected LCCs, and 28 showed a single, peripheral, and well-defined solid nodule or mass with regularly smooth (39 %), lobulated (43 %), or spiculated (18 %) margins. One case presented as hilar mass. In 9 incident LCCs, smaller solid nodules were identified in prior LDCT examinations, allowing us to calculate a mean Volume Doubling Time (VDT) of 98.7 ± 47.8 days. The overall five-year survival rate was 50 %, with a significant (p = 0.0001) difference between stages I-II (75 % alive) and stages III-IV (10 % alive).</p></div><div><h3>Conclusions</h3><p>LCC is a fast-growing neoplasm that can escape detection by annual LDCT screening. LCC typically presents as a single solid peripheral nodule or mass, often with lobulated margins, and exhibits a short VDT. The 5-year survival reflects the stage at diagnosis.</p></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Initial interpretation scores of screening mammograms and cancer detection in BreastScreen Norway 挪威 "乳房筛查 "项目乳房 X 射线检查和癌症检测的初步判读分数

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology

Pub Date : 2024-08-13 DOI: 10.1016/j.ejrad.2024.111662

Purpose

To explore the association between radiologists’ interpretation scores, early performance measures and cumulative reading volume in mammographic screening.

Method

We analyzed 1,689,731 screening examinations (3,379,462 breasts) from BreastScreen Norway 2012–2020, all breasts scored 1–5 by two independent radiologists. Score 1 was considered negative/benign and score ≥2 positive in this scoring system. We performed descriptive analyses of recall, screen-detected cancer, positive predictive value (PPV) 1, mammographic features and histopathological characteristics by breast-based interpretation scores, and cumulative reading volume by examination-based interpretation scores.

Results

Counting breasts and not women, 3.9 % (132,570/3,379,462) had a score of ≥2 by one or both radiologists. Of these, 84.8 % (112,440/132,570) were given a maximum score 2. Total recall rate was 1.6 % (53,735/3,379,462), 69.3 % (37,220/53,735) given maximum score 2. Among the 0.3 % (9733/3,379,462) diagnosed with screen-detected cancer, 34.6 % (3369/9733) had maximum score 3. The percentages of recall, screen-detected cancer and PPV-1 increased by increasing the sum of scores assigned by two radiologists (p < 0.001 for trend). Higher proportions of masses were observed among recalls and screen-detected cancers with low scores, and higher proportions of spiculated masses were observed for high scores (p < 0.001). Proportions of invasive carcinoma, histological grade 3 and lymph node positive tumors were higher for high versus low scores (p < 0.001). The proportion of examinations scored 1 increased by cumulative reading volume.

Conclusions

We observed higher rates of recall and screen-detected cancer and less favorable histopathological tumor characteristics for high versus low interpretation scores. However, a considerable number of recalls and screen-detected cancers had low interpretation scores.

方法我们分析了2012-2020年挪威乳腺癌筛查（BreastScreen Norway）的1,689,731例筛查（3,379,462个乳房），所有乳房均由两名独立放射科医生打1-5分。在该评分系统中，1分被视为阴性/良性，≥2分被视为阳性。我们对召回率、筛查出的癌症、阳性预测值 (PPV)1、基于乳房的判读评分的乳房造影特征和组织病理学特征，以及基于检查的判读评分的累计读片量进行了描述性分析。结果算上乳房而不是女性，3.9%（132,570/3,379,462）的乳房在一位或两位放射科医生的评分下≥2分。其中，84.8%（112,440/132,570）的最高评分为 2 分。总召回率为 1.6%（53,735/3,379,462），69.3%（37,220/53,735）为最高 2 分。在 0.3%（9733/3,379,462）被诊断为筛查出的癌症患者中，34.6%（3369/9733）的最高评分为 3 分。召回、筛查出癌症和 PPV-1 的比例随着两名放射科医生评分总和的增加而增加（趋势为 p < 0.001）。在低分的召回和筛查出的癌症中，肿块的比例较高，而在高分的癌症中，棘状肿块的比例较高（p <0.001）。高分与低分相比，浸润癌、组织学 3 级和淋巴结阳性肿瘤的比例更高（p < 0.001）。结论我们观察到，判读分数高与判读分数低相比，召回率和筛查出癌症的比例较高，组织病理学肿瘤特征较差。然而，相当多的复查和筛查出的癌症的判读分数较低。

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引用次数: 0

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