Abstract:
The most common idiopathic interstitial lung disease (ILD) is idiopathic pulmonary fibrosis (IPF). It can be identified by the presence of usual interstitial pneumonia (UIP) via high-resolution computed tomography (HRCT) or with the use of a lung biopsy. We hypothesized that a CT-based approach using handcrafted radiomics might be able to identify IPF patients with a radiological or histological UIP pattern from those with an ILD or normal lungs. A total of 328 patients from one center and two databases participated in this study. Each participant had their lungs automatically contoured and sectorized. The best radiomic features were selected for the random forest classifier and performance was assessed using the area under the receiver operator characteristics curve (AUC). A significant difference in the volume of the trachea was seen between a normal state, IPF, and non-IPF ILD. Between normal and fibrotic lungs, the AUC of the classification model was 1.0 in validation. When classifying between IPF with a typical HRCT UIP pattern and non-IPF ILD the AUC was 0.96 in validation. When classifying between IPF with UIP (radiological or biopsy-proved) and non-IPF ILD, an AUC of 0.66 was achieved in the testing dataset. Classification between normal, IPF/UIP, and other ILDs using radiomics could help discriminate between different types of ILDs via HRCT, which are hardly recognizable with visual assessments. Radiomic features could become a valuable tool for computer-aided decision-making in imaging, and reduce the need for unnecessary biopsies.
摘要:
最常见的特发性间质性肺病(ILD)是特发性肺纤维化(IPF)。可以通过高分辨率计算机断层扫描(HRCT)或使用肺活检通过常见的间质性肺炎(UIP)的存在来识别。我们假设使用手工制作的影像组学的基于CT的方法可能能够从ILD或正常肺的患者中识别出具有放射学或组织学UIP模式的IPF患者。来自一个中心和两个数据库的328名患者参与了这项研究。每个参与者的肺部自动轮廓化和分区化。为随机森林分类器选择最佳放射学特征,并使用接受者操作员特征曲线(AUC)下的面积评估性能。在正常状态下观察到气管体积的显着差异,IPF,和非IPFILD。在正常肺和纤维化肺之间,验证时分类模型的AUC为1.0.当在具有典型HRCTUIP模式的IPF和非IPFILD之间进行分类时,AUC在验证中为0.96。在使用UIP(放射学或活检证实)的IPF和非IPFILD之间进行分类时,测试数据集中的AUC为0.66.正常之间的分类,IPF/UIP,和其他使用影像组学的ILD可以通过HRCT帮助区分不同类型的ILD,用视觉评估很难辨认。放射学特征可以成为成像计算机辅助决策的有价值的工具,减少不必要的活检。