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RNAF: Regularization neural attenuation fields for sparse-view CBCT reconstruction. RNAF:稀疏视图CBCT重构的正则化神经衰减场。
IF 1.4 3区 医学 Q3 INSTRUMENTS & INSTRUMENTATION Pub Date : 2025-07-01 Epub Date: 2025-03-25 DOI: 10.1177/08953996241301661
Chunjie Xia, Tianyun Gu, Nan Zheng, Hongjiang Wei, Tsung-Yuan Tsai

Cone beam computed tomography (CBCT) is increasingly used in clinical settings, with the radiation dose incurred during X-ray acquisition emerging as a critical concern. Traditional algorithms for reconstructing high-quality CBCT images typically necessitate hundreds of X-ray projections, prompting a shift towards sparse-view CBCT reconstruction as a means to minimize radiation exposure. A novel approach, leveraging the Neural Attenuation Field (NAF) based on neural radiation field algorithms, has recently gained traction. This method offers rapid and promising CBCT reconstruction outcomes using a mere 50 views. Nonetheless, NAF tends to overlook the inherent structural properties of projected images, which can lead to shortcomings in accurately capturing the structural essence of the object being imaged. To address these limitations, we introduce an enhanced method: Regularization Neural Attenuation Fields (RNAF). Our approach includes two key innovations. First, we implement a hash coding regularization technique designed to retain low-frequency details within the reconstructed images, thereby preserving essential structural information. Second, we incorporate a Local Patch Global (LPG) sampling strategy. This method focuses on extracting local geometric details from the projection image, ensuring that the intensity variations in randomly sampled X-rays closely mimic those in the actual projection image. Comparative analyses across various body parts (Chest, Jaw, Foot, Abdomen, Knee) reveal that RNAF substantially outperforms existing algorithms. Specifically, its reconstruction quality exceeds that of previous NeRF-based, optimization-based, and analysis algorithms by margins of at least 2.09 dB, 3.09 dB, and 13.84 dB respectively. This significant enhancement in performance underscores the potential of RNAF as a groundbreaking solution in the realm of CBCT imaging, offering a path towards achieving high-quality reconstructions with reduced radiation exposure. Our implementation is publically available at https://github.com/springXIACJ/FRNAF.

锥形束计算机断层扫描(CBCT)越来越多地应用于临床环境,在x射线采集过程中产生的辐射剂量成为一个关键问题。重建高质量CBCT图像的传统算法通常需要数百个x射线投影,这促使人们转向稀疏视图CBCT重建,以减少辐射暴露。一种基于神经辐射场算法的神经衰减场(NAF)新方法最近得到了关注。该方法仅使用50个视图即可提供快速且有希望的CBCT重建结果。然而,NAF往往忽略了投影图像的固有结构特性,这可能导致在准确捕捉被成像对象的结构本质方面存在缺陷。为了解决这些限制,我们引入了一种增强的方法:正则化神经衰减场(RNAF)。我们的方法包括两个关键创新。首先,我们实现了一种哈希编码正则化技术,旨在保留重建图像中的低频细节,从而保留基本的结构信息。其次,我们采用了本地补丁全局(LPG)采样策略。该方法侧重于从投影图像中提取局部几何细节,确保随机采样x射线的强度变化与实际投影图像中的强度变化非常接近。对不同身体部位(胸部、下巴、脚、腹部、膝盖)的比较分析表明,RNAF实质上优于现有算法。具体而言,其重建质量分别比以往基于nerf、基于优化和基于分析的算法至少高出2.09 dB、3.09 dB和13.84 dB。这一显著的性能增强强调了RNAF作为CBCT成像领域突破性解决方案的潜力,为减少辐射暴露实现高质量重建提供了一条途径。我们的实现可以在https://github.com/springXIACJ/FRNAF上公开获得。
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引用次数: 0
LungNet-ViT: Efficient lung disease classification using a multistage vision transformer model from chest radiographs. LungNet-ViT:利用胸部x线片的多阶段视觉转换模型进行有效的肺部疾病分类。
IF 1.4 3区 医学 Q3 INSTRUMENTS & INSTRUMENTATION Pub Date : 2025-07-01 Epub Date: 2025-03-28 DOI: 10.1177/08953996251320262
V Padmavathi, Kavitha Ganesan

This research introduces a Multistage-Vision Transformer (Multistage-ViT) model for precisely classifying various lung diseases using chest radiographic (CXR) images. The dataset in the proposed method includes four classes: Normal, COVID-19, Viral Pneumonia and Lung Opacity. This model demonstrates its efficacy on imbalanced and balanced datasets by enhancing classifier accuracy through deep feature extraction. It integrates backbone models with the ViT architecture, creating rigorously hybrid configurations compared to their standalone counterparts. These hybrid models utilize optimized features for classification, significantly improving their performance. Notably, the multistage-ViT model achieved accuracies of 99.93% on an imbalanced dataset and 99.97% on a balanced dataset using the InceptionV3 combined with the ViT model. These findings highlight the superior accuracy and robustness of multistage-ViT models, underscoring their potential to enhance lung disease classification through advanced feature extraction and model integration techniques. The proposed model effectively demonstrates the benefits of employing ViT for deep feature extraction from CXR images.

本研究介绍了一种多级视觉转换器(Multistage-ViT)模型,用于利用胸部x线摄影(CXR)图像对各种肺部疾病进行精确分类。该方法的数据集包括四类:正常、COVID-19、病毒性肺炎和肺不透明。该模型通过深度特征提取来提高分类器的准确率,证明了其在不平衡和平衡数据集上的有效性。它将骨干模型与ViT体系结构集成在一起,与独立模型相比,创建了严格的混合配置。这些混合模型利用优化的特征进行分类,显著提高了它们的性能。值得注意的是,使用与ViT模型相结合的InceptionV3, multistage-ViT模型在不平衡数据集上实现了99.93%的准确率,在平衡数据集上实现了99.97%的准确率。这些发现突出了多阶段vit模型优越的准确性和鲁棒性,强调了它们通过先进的特征提取和模型集成技术增强肺部疾病分类的潜力。该模型有效地证明了利用ViT对CXR图像进行深度特征提取的好处。
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引用次数: 0
Cone-beam computed laminography frequency domain information distribution and missing model. 锥束层析成像频域信息分布与缺失模型
IF 1.4 3区 医学 Q3 INSTRUMENTS & INSTRUMENTATION Pub Date : 2025-07-01 Epub Date: 2025-03-25 DOI: 10.1177/08953996251325786
Hui Han, Yu Han, Yanmin Sun, Liyang Zhang, Xiaoqi Xi, Lei Li, Bin Yan

The objective of this study is to analyse and validate the distribution and missing regions in the frequency domain space of the projection information obtained from Cone-beam Computed Laminography (CBCL) scanned samples. Furthermore, the aim is to establish a frequency domain information distribution and missing model for CBCL. This paper employs the Fourier slice theorem to ascertain the spatial region of the frequency domain wherein the CBCL projection information is situated. To this end, the geometrical structure of the CL system and the spatial propagation characteristics of the cone-beam rays are subjected to analysis. Furthermore, the veracity of the model for the missing information in the CBCL frequency domain is validated through an iterative reconstruction process, whereby different regions of the frequency domain space are reconstructed through an iterative reconstruction algorithm that takes only the projection information as a constraint. The CBCL frequency domain missing information model can be employed as a priori information in the frequency domain space to facilitate further optimisation and improvement of image reconstruction.

本研究旨在分析和验证从锥形束计算机层析成像(CBCL)扫描样本中获得的投影信息在频域空间中的分布和缺失区域。此外,本文还旨在建立 CBCL 的频域信息分布和缺失模型。本文利用傅里叶切片定理来确定 CBCL 投影信息所在的频域空间区域。为此,本文对 CL 系统的几何结构和锥束射线的空间传播特性进行了分析。此外,还通过迭代重建过程验证了 CBCL 频域缺失信息模型的真实性,即通过仅以投影信息为约束条件的迭代重建算法重建频域空间的不同区域。CBCL 频域缺失信息模型可用作频域空间的先验信息,以促进图像重建的进一步优化和改进。
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引用次数: 0
KBA-PDNet: A primal-dual unrolling network with kernel basis attention for low-dose CT reconstruction. KBA-PDNet:用于低剂量 CT 重构的具有核基关注度的基元-双展开网络。
IF 1.4 3区 医学 Q3 INSTRUMENTS & INSTRUMENTATION Pub Date : 2025-05-01 Epub Date: 2025-03-03 DOI: 10.1177/08953996241308759
Rongfeng Li, Dalin Wang

Computed tomography (CT) image reconstruction is faced with challenge of balancing image quality and radiation dose. Recent unrolled optimization methods address low-dose CT image quality issues using convolutional neural networks or self-attention mechanisms as regularization operators. However, these approaches have limitations in adaptability, computational efficiency, or preservation of beneficial inductive biases. They also depend on initial reconstructions, potentially leading to information loss and error propagation. To overcome these limitations, Kernel Basis Attention Primal-Dual Network (KBA-PDNet) is proposed. The method unrolls multiple iterations of the proximal primal-dual optimization process, replacing traditional proximal operators with Kernel Basis Attention (KBA) modules. This design enables direct training from raw measurement data without relying on preliminary reconstructions. The KBA module achieves adaptability by learning and dynamically fusing kernel bases, generating customized convolution kernels for each spatial location. This approach maintains computational efficiency while preserving beneficial inductive biases of convolutions. By training end-to-end from raw projection data, KBA-PDNet fully utilizes all original information, potentially capturing details lost in preliminary reconstructions. Experiments on simulated and clinical datasets demonstrate that KBA-PDNet outperforms existing approaches in both image quality and computational efficiency.

计算机断层扫描(CT)图像重建面临着平衡图像质量和辐射剂量的挑战。最近推出的优化方法使用卷积神经网络或自关注机制作为正则化算子来解决低剂量CT图像质量问题。然而,这些方法在适应性、计算效率或保留有益的归纳偏差方面存在局限性。它们还依赖于初始重建,这可能导致信息丢失和错误传播。为了克服这些限制,提出了核基注意原对偶网络(KBA-PDNet)。该方法展开近端原始对偶优化过程的多次迭代,用核基注意(KBA)模块取代传统的近端算子。这种设计可以从原始测量数据直接训练,而不依赖于初步重建。KBA模块通过学习和动态融合核基来实现自适应性,为每个空间位置生成定制的卷积核。这种方法保持了计算效率,同时保留了有益的卷积归纳偏差。通过对原始投影数据进行端到端训练,KBA-PDNet充分利用了所有原始信息,潜在地捕获了初步重建中丢失的细节。在模拟和临床数据集上的实验表明,KBA-PDNet在图像质量和计算效率方面都优于现有方法。
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引用次数: 0
Multi-limited-angle spectral CT image reconstruction based on average image induced relative total variation model. 基于平均图像诱导相对全变分模型的多限角光谱CT图像重建。
IF 1.4 3区 医学 Q3 INSTRUMENTS & INSTRUMENTATION Pub Date : 2025-05-01 Epub Date: 2025-03-17 DOI: 10.1177/08953996251314771
Zhaoqiang Shen, Yumeng Guo

In recent years, spectral computed tomography (CT) has attracted extensive attention. The purpose of this study is to achieve a low-cost and fast energy spectral CT reconstruction algorithm by implementing multi-limited-angle scans. General spectral CT projection data are collected over a full-angular range of 360 degrees. We simulate multi-source spectral CT by using a pair of X-ray source/detector. To speed up scanning, multi-limited-angle scanning was used in each energy channel. On this basis, an average image induced relative total variation (Aii-RTV) with multi-limited-angle spectral CT image reconstruction model is proposed. The iterative algorithm is used to solve Aii-RTV. Before iteration, the weighted average projection data of the multi-limited-angle energy spectral is carried out. In each step of the iterative algorithm flow is as follows: First, the relative total variation (RTV) reconstruction model is used to reconstruct the average image using average projection data. Then, the partial derivative of the average image is used to calculate the inherent variation in RTV model due to the integrity of the average image, and take its reciprocal as the weight coefficient of the windowing total variation of each energy channel reconstruction image. Finally, the average energy image is used to guide the multi-limited-angle projection data to reconstruct the image of each energy channel so as to suppress the limited-angle artifact of each energy channel image. In addition, we also discuss the influence of parameter selection on reconstructed image quality, which is important for regularization model. Through the reconstruction of multi-limited-angle spectral CT projection data, quantitative results and reconstructed images show that our algorithm has better performance than prior image constrained compressed sensing (PICCS) and RTV. The average PSNR of our reconstruction results in different channels was 35.6273, 4.533 and 2.301 higher than RTV (31.0943) and PICCS (33.3263), respectively.

近年来,光谱计算机断层扫描(CT)引起了广泛的关注。本研究的目的是通过实现多限角扫描,实现一种低成本、快速的能谱CT重建算法。一般的光谱CT投影数据是在360度的全角度范围内收集的。我们利用一对x射线源/探测器模拟了多源光谱CT。为了加快扫描速度,在每个能量通道上都采用了多限角扫描。在此基础上,提出了一种具有多限制角度的平均图像诱导相对总变差(ai - rtv)的光谱CT图像重建模型。采用迭代算法求解ai - rtv。迭代前,对多限角能谱进行加权平均投影数据处理。迭代算法的每一步流程如下:首先,采用相对总变差(relative total variation, RTV)重建模型,利用平均投影数据重建平均图像。然后,利用平均图像的偏导数计算RTV模型由于平均图像的完整性而产生的固有变化,并将其倒数作为各能量通道重构图像加窗总变化的权重系数。最后,利用平均能量图像引导多限角投影数据重构各能量通道图像,从而抑制各能量通道图像的限角伪影。此外,我们还讨论了参数选择对重构图像质量的影响,这是正则化模型的重要组成部分。通过对多限角光谱CT投影数据的重建,定量结果和重建图像表明,该算法比先验图像约束压缩感知(PICCS)和RTV具有更好的性能。不同通道重建结果的平均PSNR分别比RTV(31.0943)和PICCS(33.3263)高35.6273、4.533和2.301。
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引用次数: 0
Comparative analysis of machine learning and deep learning algorithms for knee arthritis detection using YOLOv8 models. 基于YOLOv8模型的机器学习和深度学习算法在膝关节关节炎检测中的比较分析。
IF 1.4 3区 医学 Q3 INSTRUMENTS & INSTRUMENTATION Pub Date : 2025-05-01 Epub Date: 2025-02-26 DOI: 10.1177/08953996241308770
Ilkay Cinar

Knee arthritis is a prevalent joint condition that affects many people worldwide. Early detection and appropriate treatment are essential to slow the disease's progression and enhance patients' quality of life. In this study, various machine learning and deep learning algorithms were used to detect knee arthritis. The machine learning models included k-NN, SVM, and GBM, while DenseNet, EfficientNet, and InceptionV3 were used as deep learning models. Additionally, YOLOv8 classification models (YOLOv8n-cls, YOLOv8s-cls, YOLOv8m-cls, YOLOv8l-cls, and YOLOv8x-cls) were employed. The "Annotated Dataset for Knee Arthritis Detection" with five classes (Normal, Doubtful, Mild, Moderate, Severe) and 1650 images were divided into 80% training, 10% validation, and 10% testing using the Hold-Out method. YOLOv8 models outperformed both machine learning and deep learning algorithms. k-NN, SVM, and GBM achieved success rates of 63.61%, 64.14%, and 67.36%, respectively. Among deep learning models, DenseNet, EfficientNet, and InceptionV3 achieved 62.35%, 70.59%, and 79.41%. The highest success was seen in the YOLOv8x-cls model at 86.96%, followed by YOLOv8l-cls at 86.79%, YOLOv8m-cls at 83.65%, YOLOv8s-cls at 80.37%, and YOLOv8n-cls at 77.91%.

膝关节炎是一种普遍的关节疾病,影响着全世界许多人。早期发现和适当治疗对于减缓疾病进展和提高患者的生活质量至关重要。在这项研究中,各种机器学习和深度学习算法被用于检测膝关节关节炎。机器学习模型包括k-NN、SVM和GBM,深度学习模型采用DenseNet、EfficientNet和InceptionV3。采用YOLOv8分类模型(YOLOv8n-cls、YOLOv8s-cls、YOLOv8m-cls、YOLOv8l-cls、YOLOv8x-cls)。“膝关节关节炎检测的注释数据集”有五个类别(正常,可疑,轻度,中度,严重)和1650张图像,使用Hold-Out方法分为80%的训练,10%的验证和10%的测试。YOLOv8模型的表现优于机器学习和深度学习算法。k-NN、SVM和GBM的成功率分别为63.61%、64.14%和67.36%。在深度学习模型中,DenseNet、EfficientNet和InceptionV3分别达到了62.35%、70.59%和79.41%。YOLOv8x-cls模型的最高成功率为86.96%,其次是YOLOv8l-cls(86.79%)、yolov800 m-cls(83.65%)、YOLOv8s-cls(80.37%)和YOLOv8n-cls(77.91%)。
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引用次数: 0
Performance of a focused 2D anti-scatter grid for industrial X-ray computed tomography. 用于工业x射线计算机断层扫描的聚焦二维抗散射网格的性能。
IF 1.4 3区 医学 Q3 INSTRUMENTS & INSTRUMENTATION Pub Date : 2025-05-01 Epub Date: 2025-03-25 DOI: 10.1177/08953996251325072
Joseph John Lifton, Zheng Jie Tan, Christian Filemon

X-ray computed tomography (XCT) is increasingly being used for the measurement and inspection of large dense metallic engineering components. When scanning such components, the quality of the data is degraded by the presence of scattered radiation. In this work, the performance of a focused 2D anti-scatter grid (ASG) is investigated for scanning samples made from cobalt chrome and Inconel on a 450 kV cone-beam XCT system. The devised scatter correction method requires one additional scan of the sample, and for projections to be algorithmically processed prior to reconstruction. The results show that the ASG based scatter correction method increases the contrast-to-noise of the data by 14.5% and 61.5% for the cobalt chrome and Inconel samples, respectively. Furthermore, the method increases edge sharpness by 6% and 16.9% for outer and inner edges, respectively.

X 射线计算机断层扫描 (XCT) 越来越多地用于测量和检测大型致密金属工程部件。在扫描此类部件时,散射辐射的存在会降低数据质量。在这项工作中,研究了聚焦二维反散射网格(ASG)在 450 kV 锥束 XCT 系统上扫描钴铬合金和铬镍铁合金样品时的性能。所设计的散射校正方法需要对样品进行一次额外扫描,并在重建之前对投影进行算法处理。结果表明,基于 ASG 的散射校正方法可将钴铬合金和铬镍铁合金样品的数据对比度-噪声分别提高 14.5% 和 61.5%。此外,该方法还将外边缘和内边缘的边缘锐度分别提高了 6% 和 16.9%。
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引用次数: 0
Multi-axis transformer based U-Net with class balanced ensemble model for lung disease classification using X-ray images. 基于多轴变压器的U-Net类平衡集成模型用于肺部疾病x射线图像分类。
IF 1.4 3区 医学 Q3 INSTRUMENTS & INSTRUMENTATION Pub Date : 2025-05-01 Epub Date: 2025-02-26 DOI: 10.1177/08953996251317416
Suresh Maruthai, Tamilvizhi Thanarajan, T Ramesh, Surendran Rajendran

Background: Chest X-rays are an essential diagnostic tool for identifying chest disorders because of its high sensitivity in detecting pathological anomalies in the lungs. Classification models based on conventional Convolutional Neural Networks (CNNs) are adversely affected due to their localization bias. Objective: In this paper, a new Multi-Axis Transformer based U-Net with Class Balanced Ensemble (MaxTU-CBE) is proposed to improve multi-label classification performance. Methods: This may be the first attempt to simultaneously integrate the benefits of hierarchical Multi-Axis Transformer into the encoder and decoder of the traditional U-shaped structure for improving the semantic segmentation superiority of lung image. Results: A key element of MaxTU-CBE is the Contextual Fusion Engine (CFE), which uses the self-attention mechanism to efficiently create global interdependence between features of various scales. Also, deep CNN incorporate ensemble learning to address the issue of class unbalanced learning. Conclusions: According to experimental findings, our suggested MaxTU-CBE outperforms the competing BiDLSTM classifier by 1.42% and CBIR-CSNN techniques by 5.2% in multi-label classification performance.

背景:胸部x光片是诊断胸部疾病的重要工具,因为它在检测肺部病理异常方面具有很高的灵敏度。基于传统卷积神经网络(cnn)的分类模型由于其定位偏差而受到不利影响。目的:为了提高多标签分类性能,提出了一种新的基于类平衡集成的多轴变压器U-Net (MaxTU-CBE)。方法:这可能是首次尝试将分层多轴转换器的优点同时融入传统u型结构的编码器和解码器中,以提高肺部图像的语义分割优势。结果:MaxTU-CBE的关键元素是上下文融合引擎(CFE),它利用自注意机制有效地在不同尺度的特征之间建立全局相互依存关系。此外,深度CNN结合集成学习来解决类不平衡学习的问题。结论:根据实验结果,我们建议的MaxTU-CBE在多标签分类性能上比竞争对手BiDLSTM分类器高1.42%,比cbirr - csnn技术高5.2%。
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引用次数: 0
New method for diffusion-weighted images denoising based on patch-matching with higher-order singular value decomposition. 基于高阶奇异值分解的补丁匹配扩散加权图像去噪新方法。
IF 1.4 3区 医学 Q3 INSTRUMENTS & INSTRUMENTATION Pub Date : 2025-05-01 Epub Date: 2025-02-26 DOI: 10.1177/08953996241313321
Liming Yang, Yuanjun Wang

BackgroundDiffusion-weighted imaging (DWI) is an important technique to study brain microstructure. However, diffusion-weighted (DW) images suffer from severe low signal-to-noise ratio (SNR) problem, affecting subsequent diffusion analysis.ObjectiveThe goal of this paper is to develop advanced DWI denoising technique to effectively reduce noise while improving the accuracy and reliability of subsequent diffusion model fitting and diffusion analysis, thereby facilitating the research and analysis of brain science.MethodsWe propose a new method for denoising DW images based on patch-matching with higher-order singular value decomposition (HOSVD) by combined with the variance-stabilizing transformation technique. It starts with introducing a novel non-local mean algorithm as a prefiltering stage, and then denoises the noisy data using a local HOSVD algorithm based on the HOSVD bases learned from prefiltered images.ResultsExperiments are performed on simulation, HCP and in vivo brain DWI datasets. Results show that the proposed method significantly reduces spatially invariant and variant noise, improving the most reliable diffusion analysis compared with the different denoising methods.ConclusionsThe proposed method achieves state-of-the-art performance which can improve image quality and enable accurate diffusion analysis.

背景弥散加权成像(DWI)是研究脑微观结构的一项重要技术。然而,扩散加权图像存在严重的低信噪比问题,影响了后续的扩散分析。目的开发先进的DWI去噪技术,在有效降低噪声的同时,提高后续扩散模型拟合和扩散分析的准确性和可靠性,从而促进脑科学研究和分析。方法提出了一种基于高阶奇异值分解(HOSVD)补丁匹配和方差稳定变换相结合的DW图像去噪方法。首先引入一种新颖的非局部均值算法作为预滤波阶段,然后基于从预滤波图像中学习到的HOSVD基,采用局部HOSVD算法对噪声数据进行去噪。结果分别在模拟、HCP和活体脑DWI数据集上进行了实验。结果表明,与其他去噪方法相比,该方法显著降低了空间不变噪声和变异噪声,提高了最可靠的扩散分析。结论该方法能够提高图像质量,实现准确的扩散分析。
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引用次数: 0
Radiomics from dual-energy CT-derived iodine maps for predicting lymph node metastases in patients with resectable rectal cancer. 双能ct衍生碘图放射组学预测可切除直肠癌患者淋巴结转移。
IF 1.4 3区 医学 Q3 INSTRUMENTS & INSTRUMENTATION Pub Date : 2025-05-01 Epub Date: 2025-02-25 DOI: 10.1177/08953996241313322
Xia Liu, Yi Yuan, Xiao-Li Chen, Zhu Fang, Si-Yun Liu, Hong Pu, Hang Li

BackgroundLymph node metastasis (LNM) is a poor prognostic predictor and is highly correlated with local recurrence in rectal cancer patients.ObjectiveTo investigate the value of radiomics from dual-energy CT-derived iodine maps for the preoperative prediction of LNM in rectal cancer patients.MethodsA total of 176 patients were enrolled in this study (training group, n = 123; validation group, n = 53). A radiomic signature was constructed via support vector machine (SVM) modeling. Seven models, including a clinical feature model (Model 1), an arterial model (Model 2), a venous model (Model 3), an arterial-venous model (Model 4), an arterial-clinical model (Model 5), a venous-clinical model (Model 6) and an arterial-venous-clinical model (Model 7), were established via logistic regression modeling. Diagnostic performance was assessed via receiver operating characteristic (ROC) curves.ResultsTumor location and carcinoembryonic antigen levels were used to construct Model 1 (training group, AUC [area under the ROC curve] = 0.721, 95% CI [confidence intervals], 0.630-0.813; validation group, AUC = 0.729, 95% CI, 0.593-0.865). Model 6 and Model 7 further improved the discriminatory performance in the training (AUC = 0.850 and 0.869, 95% CI, 0.782-0.919 and 0.807-0.932, respectively; p = 0.250) and validation groups (AUC = 0.780 and 0.716, 95% CI, 0.653-0.906 and 0.576-0.856, respectively; p = 0.115). Moreover, decision curve analysis revealed a greater net benefit with Model 6.ConclusionsThe combination of radiomic features based on dual-energy CT-derived iodine maps and clinical features provides better diagnostic performance for predicting LNM in rectal cancer patients.

背景:在直肠癌患者中,淋巴结转移(LNM)是一个较差的预后预测因子,与局部复发高度相关。目的探讨双能ct碘图放射组学对直肠癌患者LNM术前预测的价值。方法共纳入176例患者(训练组,n = 123;验证组,n = 53)。通过支持向量机(SVM)建模构建了放射性特征。通过logistic回归模型建立临床特征模型(模型1)、动脉模型(模型2)、静脉模型(模型3)、动-静脉模型(模型4)、动脉-临床模型(模型5)、静脉-临床模型(模型6)、动-静脉-临床模型(模型7)等7个模型。通过受试者工作特征(ROC)曲线评估诊断效果。结果采用肿瘤位置和癌胚抗原水平构建模型1(训练组,AUC [ROC曲线下面积]= 0.721,95% CI[置信区间],0.630-0.813;验证组,AUC = 0.729, 95% CI, 0.593-0.865)。模型6和模型7在训练中进一步提高了区分绩效(AUC分别为0.850和0.869,95% CI分别为0.782-0.919和0.807-0.932;p = 0.250)和验证组(AUC分别为0.780和0.716,95% CI分别为0.653-0.906和0.576-0.856;p = 0.115)。此外,决策曲线分析显示模型6的净效益更大。结论基于双能ct碘图的放射学特征与临床特征相结合对预测直肠癌LNM有较好的诊断价值。
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