X-ray computed

X 线计算
  • 文章类型: Journal Article
    影像学的发展积极塑造了该领域的临床管理。超声检查(美国),计算机断层扫描血管造影(CTA),磁共振血管造影(MRA)是研究最广泛的ABR成像方式。正在进行的进步包括“实时”血管造影和三维(3D)表面成像,未来的前景包括增强或虚拟现实(AR/VR)和人工智能(AI)。这些技术可以进一步提高围手术期的效率,减少供体部位的发病率,并改善ABR的手术结局。
    The evolution of imaging actively shapes clinical management in the field. Ultrasonography (US), computed tomography angiography (CTA), and magnetic resonance angiography (MRA) stand out as the most extensively researched imaging modalities for ABR. Ongoing advancements include \"real-time\" angiography and three-dimensional (3D) surface imaging, and future prospects incorporate augmented or virtual reality (AR/VR) and artificial intelligence (AI). These technologies may further enhance perioperative efficiency, reduce donor-site morbidity, and improve surgical outcomes in ABR.
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  • 文章类型: Journal Article
    要确定成像模式/对比度的组合,影像组学模型,以及使用影像组学方法,有多少特征为区分低度和高度软组织肉瘤(STS)提供了最佳诊断性能。
    对39例经组织学证实的STS患者的MRI和CT进行前瞻性分析。通过影像组学模型对图像进行定量评估,并通过视觉评估(用作参考)对图像进行定性评估,以进行分级(低级vs高级)。在影像组学分析中,提取了120个放射学特征,并将其贡献到三个模型中:带逻辑回归的最小绝对收缩和选择算子(LASSO-LR),递归特征消除和交叉验证(RFECV-SVC)以及与SVC的方差分析(ANOVA-SVC)。这些被应用于不同的成像方式采集组合,有或没有造影剂给药,以及选定的功能数量。
    使用涉及五个特征的RFECV-SVC放射组学模型的脂肪饱和T2w(FS-T2w)MR图像产生了具有平均灵敏度的最佳结果,特异性,准确率为92%±10%,78%±30%,89%±12%,分别。对于STS分级,影像组学的性能优于常规分析(67%的准确性)。多种对比或成像方式的组合并没有增加诊断性能。
    FS-T2wMR图像与使用REFCV-SVC模型的五特征影像组学分析相比于传统的多重MRI造影和CT成像视觉评估,可能能够提供足够的诊断性能。
    UNASSIGNED: To determine which combination of imaging modalities/contrast, radiomics models, and how many features provides the best diagnostic performance for the differentiation between low- and high-grade soft tissue sarcomas (STS) using a radiomics approach.
    UNASSIGNED: MRI and CT from 39 patients with a histologically confirmed STS were prospectively analyzed. Images were evaluated both quantitatively by radiomics models and qualitatively by visual evaluation (used as reference) for grading (low-grade vs high-grade). In radiomics analysis, 120 radiomic features were extracted and contributed into three models: least absolute shrinkage and selection operator with logistic regression(LASSO-LR), recursive feature elimination and cross-validation (RFECV-SVC) and analysis of variance with SVC (ANOVA-SVC). Those were applied to different combinations of imaging modalities acquisition, with and without contrast medium administration, as well as selected number of features.
    UNASSIGNED: Fat-saturated T2w (FS-T2w) MR images using RFECV-SVC radiomic models involving five features yielded the best results with mean sensitivity, specificity, and accuracy of 92% ± 10%, 78% ± 30%, and 89% ± 12%, respectively. The performance of radiomics was better than that of conventional analysis (67% accuracy) for STS grading. Combination of multiple contrast or imaging modalities did not increase the diagnostic performance.
    UNASSIGNED: FS-T2w MR images alone with a five-feature radiomics analysis usingh REFCV-SVC model may be able to provide sufficient diagnositic performance compared to conventional visual evaluation with multiple MRI contrast and CT imaging.
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  • 文章类型: Journal Article
    结直肠癌肝转移灶(CRLM)周围组织的影像组学分析提高了病理数据和生存率的预测准确性。我们探索了随着与CRLM的距离增加,肿瘤周围组织中纹理特征的变化。我们考虑了低密度CRLM>10mm和高质量计算机断层扫描(CT)的患者。在门户阶段,我们分割(1)肿瘤,(2)与CRLM的距离逐渐增加(从1毫米到10毫米)的一系列同心轮辋,和(3)正常实质的圆柱体(肝脏-VOI)。分析了51例患者的63例CRLM。腔周HU中位数与肝脏VOI相似,除了CRLM周围的第一个毫米。熵逐渐降低(从CRLM的3.11到肝脏VOI的2.54),而均匀度增加(从0.135增加到0.199,p<0.001)。距离CRLM10毫米处,在62%的病例中,熵与肝脏-VOI相似,在46%的病例中,熵与肝脏-VOI相似。在小CRLM(≤30mm)和化疗应答者中,熵值和均匀度值的归一化发生在较高比例的情况下,并且距离较短。尽管放射学方面正常,但对CRLM周围薄壁组织的放射学分析揭示了熵逐渐降低和均匀性增加的广泛光环。应调查基础病理数据。
    The radiomic analysis of the tissue surrounding colorectal liver metastases (CRLM) enhances the prediction accuracy of pathology data and survival. We explored the variation of the textural features in the peritumoural tissue as the distance from CRLM increases. We considered patients with hypodense CRLMs >10 mm and high-quality computed tomography (CT). In the portal phase, we segmented (1) the tumour, (2) a series of concentric rims at a progressively increasing distance from CRLM (from one to ten millimetres), and (3) a cylinder of normal parenchyma (Liver-VOI). Sixty-three CRLMs in 51 patients were analysed. Median peritumoural HU values were similar to Liver-VOI, except for the first millimetre around the CRLM. Entropy progressively decreased (from 3.11 of CRLM to 2.54 of Liver-VOI), while uniformity increased (from 0.135 to 0.199, p < 0.001). At 10 mm from CRLM, entropy was similar to the Liver-VOI in 62% of cases and uniformity in 46%. In small CRLMs (≤30 mm) and responders to chemotherapy, normalisation of entropy and uniformity values occurred in a higher proportion of cases and at a shorter distance. The radiomic analysis of the parenchyma surrounding CRLMs unveiled a wide halo of progressively decreasing entropy and increasing uniformity despite a normal radiological aspect. Underlying pathology data should be investigated.
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  • 文章类型: Journal Article
    标准化的基于共识的肩部不稳定放射学报告可能会提高临床质量,减少异质性,减少工作量。因此,这项研究的目的是确定X射线的重要元素,磁共振成像(MRI)关节造影(MRA),和计算机断层扫描(CT)报告,变异性的程度,和重要的MRI视图和设置。
    一个由肌肉骨骼放射科医生和骨科医生组成的专家小组在一个三轮德尔福设计中被招募。确定了X射线的重要元素,MRA,和CT报告和重要的MRI视图和设置。这些以0-9李克特量表进行评级。高变异性定义为1-3和7-9之间的至少一个分数。当≥80%得分为1-3或7-9时,达成共识。
    专家小组由21名肌肉骨骼放射科医师和15名骨科医生组成。第一轮x光报告中确定的元素数量为17个,52用于MRA,21为CT,和23用于MRI方案。达成共识的元素数量是X射线的五个,MRA的二十个,九为CT,和两个用于MRI协议。在76.5%(n=13)的X射线元素中观察到高变异性,85.0%(n=45)MRA,76.2%(n=16)CT,85.7%(n=18)的MRI方案。
    在评估肩前不稳定的放射学重要元素的评分中观察到了很大的变异性,不管模态。就X射线报告中的五个要素达成了共识,MRA报告中的20个,CT报告中有9个.最后,就关于MRA观点和设置的两个要素达成共识.
    UNASSIGNED: Standardized consensus-based radiological reports for shoulder instability may improve clinical quality, reduce heterogeneity, and reduce workload. Therefore, the aim of this study was to determine important elements for the x-ray, magnetic resonance imaging (MRI) arthrography (MRA), and computed tomography (CT) report, the extent of variability, and important MRI views and settings.
    UNASSIGNED: An expert panel of musculoskeletal radiologists and orthopedic surgeons was recruited in a three-round Delphi design. Important elements were identified for the x-ray, MRA, and CT report and important MRI views and setting. These were rated on a 0-9 Likert scale. High variability was defined as at least one score between 1-3 and 7-9. Consensus was reached when ≥80% scored an element 1-3 or 7-9.
    UNASSIGNED: The expert panel consisted of 21 musculoskeletal radiologists and 15 orthopedic surgeons. The number of elements identified in the first round was seventeen for the x-ray report, 52 for MRA, 21 for CT, and 23 for the MRI protocol. The number of elements that reached consensus was five for x-ray, twenty for MRA, nine for CT, and two for the MRI protocol. High variability was observed in 76.5% (n = 13) x-ray elements, 85.0% (n = 45) MRA, 76.2% (n = 16) CT, and 85.7% (n = 18) MRI protocol.
    UNASSIGNED: Substantial variability was observed in the scoring of important elements in the radiological for the evaluation of anterior shoulder instability, regardless of modality. Consensus was reached for five elements in the x-ray report, twenty in the MRA report, and nine in the CT report. Finally, consensus was reached on two elements regarding MRA views and settings.
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  • 文章类型: Journal Article
    去除金属引起的射束硬化伪影的常用方法通常依赖于在双能量计算机断层扫描(CT)中使用具有高管电压或高能量虚拟单能量图像的高能光子,辐射剂量通常相对较高,以产生足够的信号。这项回顾性研究旨在评估金属伪影减少(MAR)算法在减少术后小儿低辐射剂量脊柱CT图像中椎弓根螺钉金属引起的射束硬化伪影中的应用。
    纳入77名接受140或100kV低剂量CT检查的儿童(3-15岁)。3-8岁儿童的辐射剂量为1.40mGy,9-15岁儿童的辐射剂量为2.61mGy。评估了116枚椎弓根螺钉。原始数据用自适应统计迭代重建-V(ASIR-V)在50%强度下重建,ASIR-V与MAR(AV-MAR),高强度深度学习图像重建(DLIR)和带MAR的DLIR(DL-MAR)。根据射束硬化伪影(LHA)的长度和伪影指数(AI)客观地评估了椎弓根螺钉的图像质量。主观上使用4点量表(4点:最好,3分:可接受)。
    AV-MAR和DL-MAR均显着减少了具有较小LHA(15.76±10.12mm,减少57.24%和15.66±10.49毫米,减少了57.40%,分别),和AI值(62.50±33.51,减少64.65%和61.03±32.61,减少65.01%,分别)与ASIR-V和DLIR相比(均P<0.01),使用AV-MAR和DL-MAR,有关螺钉的主观图像质量评分分别为3.37±0.49和3.47±0.50,分别,高于无MAR的1.73±0.44和1.76±0.43(均P<0.01)。
    MAR显着减少了手术后儿科低剂量脊柱CT图像中金属螺钉引起的低密度伪影,跨不同的管电压,辐射剂量水平和重建算法。结合DL-MAR进一步提高了低辐射剂量条件下的整体图像质量。
    UNASSIGNED: The commonly used methods for removing metal-induced beam hardening artifacts often rely on the use of high energy photons with either high tube voltage or high energy virtual monoenergetic images in dual-energy computed tomography (CT), the radiation dose was usually relatively high in order to generate adequate signals. This retrospective study is designed to evaluate the application of a metal artifact reduction (MAR) algorithm in reducing pedicle screw metal-caused beam hardening artifacts in post-surgery pediatric low radiation dose spine CT images.
    UNASSIGNED: Seventy-seven children (3-15 years) who had undergone a low dose CT with 140 or 100 kV were enrolled. The radiation dose was 1.40 mGy for the 3-8 years old and 2.61 mGy for 9-15 years old children. There were 116 pedicle screws evaluated. The raw data were reconstructed with adaptive statistical iterative reconstruction-V (ASIR-V) at 50% strength, ASIR-V with MAR (AV-MAR), deep learning image reconstruction (DLIR) at high strength and DLIR with MAR (DL-MAR). The image quality concerning pedicle screws was evaluated objectively in terms of the length of beam-hardening artifact (LHA) and artifact index (AI), and subjectively using a 4-point scale (4 points: best, 3 points: acceptable).
    UNASSIGNED: Both AV-MAR and DL-MAR significantly reduced metal-induced beam hardening artifacts with smaller LHA (15.76±10.12 mm, a reduction of 57.24% and 15.66±10.49 mm, a reduction of 57.40%, respectively), and AI value (62.50±33.51, a reduction of 64.65% and 61.03±32.61, a reduction of 65.01%, respectively) compared to ASIR-V and DLIR (all P<0.01), The subjective image quality scores concerning the screws were 3.37±0.49 and 3.47±0.50 with AV-MAR and DL-MAR, respectively, higher than the respective value of 1.73±0.44 and 1.76±0.43 without MAR (all P<0.01).
    UNASSIGNED: MAR significantly reduces the low-density artifacts caused by metal screws in post-surgery pediatric low-dose spine CT images, across different tube voltages, radiation dose levels and reconstruction algorithms. Combining DL-MAR further improves the overall image quality under low radiation dose conditions.
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  • 文章类型: Journal Article
    背景:经皮内窥镜腰椎间盘切除术(PELD)由于其微创和快速恢复,已成为腰椎间盘突出症(LDH)的常规治疗方法。然而,PELD需要外科医生的高精度,由于术中并发症的风险很大,包括对神经根和硬脑膜的潜在损害,手术后复发的可能性更高。因此,术前计划利用CT和MRI成像至关重要.
    方法:在本研究中,回顾性分析2021年1月至2023年12月140例接受PELD治疗的LDH患者的临床资料.根据是否采用CT和MRI配准(CMR)进行手术计划,将患者分为两组:CMR组(n=68)和对照组(n=72)。收集的数据包括手术时间,住院时间,和下腰和腿部疼痛的视觉模拟量表(VAS)评分,以及日本骨科协会腰椎评分(JOA)。使用Studentt检验评估两组之间的差异。
    结果:两组间住院时间无显著差异(P=0.277)。CMR组手术时间明显缩短(P<0.001)。手术前,两组之间的腿部疼痛和下腰痛的VAS评分没有显着差异(分别为P=0.341和P=0.131);然而,术后2个月,CMR组的两项评分均显著降低(分别为P<0.001和P=0.002).同样,术前JOA评分无差异(P=0.750),但术后2个月,CMR组的评分明显较高(P<0.001).
    结论:与传统PELD相比,术前使用CMR已显示出减少手术时间,缓解腿部和腰痛,术后2个月增加腰椎JOA评分,强调其在提高手术效果方面的功效。
    BACKGROUND: Percutaneous Endoscopic Lumbar Discectomy (PELD) has emerged as routine treatment for lumbar disc herniation (LDH) due to its minimal invasiveness and quick recovery. However, PELD demands high precision from the surgeon, as the risk of intraoperative complications is substantial, including potential damage to the nerve root and dura, and a higher likelihood of recurrence post-surgery. Thus, preoperative planning utilizing CT and MRI imaging is essential.
    METHODS: In this study, the clinical data of 140 patients treated with PELD for LDH from January 2021 to December 2023 were retrospectively analyzed. Patients were categorized into two groups based on whether CT and MRI registration (CMR) was employed for surgical planning: a CMR group (n=68) and a control group (n=72). Data collected included surgery time, hospital stay duration, and scores from the Visual Analog Scale (VAS) for low back and leg pain, as well as the Japanese Orthopaedic Association Lumbar Spine Score (JOA). Differences between the two groups were assessed using the Student\'s t-test.
    RESULTS: No significant difference was found in hospital stay length between the groups (P=0.277). Surgery time was significantly shorter in the CMR group (P<0.001). Prior to surgery, no significant differences in VAS scores for leg and low back pain were observed between the groups (P=0.341 and P=0.131, respectively); however, at 2 months postoperatively, both scores were significantly lower in the CMR group (P<0.001 and P=0.002, respectively). Similarly, no difference in preoperative JOA scores was noted (P=0.750), but at 2 months postoperative, the CMR group exhibited significantly higher scores (P<0.001).
    CONCLUSIONS: Compared with the traditional PELD, the preoperative use of CMR has shown to reduce surgery time, alleviate leg and low back pain, and increase the lumbar JOA score at 2 months after surgery, underscoring its efficacy in enhancing surgical outcomes.
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  • 文章类型: Journal Article
    Although kidney transplantation is the best therapeutic option for patients with chronic kidney disease, the immunosuppression required greatly increases susceptibility to infections that are responsible for high post-transplant mortality. Pulmonary tuberculosis (TB) represents a major cause of such infections, and its early diagnosis is therefore quite important. In view of that, we researched the manifestations of active pulmonary TB in kidney transplant recipients, through chest X-ray and computed tomography (CT), as well as determining the number of cases of active pulmonary TB occurring over a 3.5-year period at our institution. We identified four cases of active pulmonary TB in kidney transplant recipients. The CT scans provided information complementary to the chest X-ray findings in all four of those cases. We compared our CT findings with those reported in the literature. We analyzed our experience in conjunction with an extensive review of the literature that was nevertheless limited because few studies have been carried out in lowand middle-income countries, where the incidence of TB is higher.
    Apesar de o transplante renal ser a melhor opção terapêutica para pacientes com doença renal crônica, a imunodepressão decorrente desse tratamento eleva muito a suscetibilidade desses pacientes a infecções, responsáveis por altas taxas de mortalidade pós-operatórias. A tuberculose (TB) pulmonar é uma significativa causa dessas infecções, sendo muito importante o seu diagnóstico precoce. Assim, nós pesquisamos as manifestações da TB pulmonar ativa nessa população de transplantados renais por meio de radiografias simples e tomografia computadorizada (TC) do tórax, também para estabelecer o número de casos de TB pulmonar ativa em nossa instituição após levantamento de 3,5 anos. Encontramos quatro casos de TB pulmonar ativa em pacientes transplantados renais. A TC forneceu informações adicionais em relação às radiografias de tórax em 100% dos casos analisados. Comparamos os nossos achados de TC com os relatados na literatura. Somamos a experiência obtida com extensa revisão da literatura, ainda limitada nessa questão, com poucos estudos realizados em países em desenvolvimento onde a incidência de TB é maior.
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  • 文章类型: Journal Article
    UNASSIGNED: To conduct a survey on the use of the term \"interstitial lung abnormalities\" in radiology reports in Brazil, propose an appropriate Portuguese-language translation for the term, and provide a brief review of the literature on the topic.
    UNASSIGNED: A survey was sent via electronic message to various radiologists in Brazil, asking about their familiarity with the term, which translation of the term they use in Portuguese, and whether they use the criteria proposed by the Fleischner Society.
    UNASSIGNED: A total of 163 responses were received, from all regions of Brazil. Although the vast majority (88%) of the respondents stated that they were familiar with the term \"interstitial lung abnormalities\", there was considerable variation regarding the equivalent term they used in Portuguese.
    UNASSIGNED: We suggest that the term \"anormalidades pulmonares intersticiais\" be used in order to standardize radiology reports and disseminate knowledge of these findings in Brazil.
    UNASSIGNED: Fazer um levantamento sobre o uso do termo interstitial lung abnormalities nos laudos radiológicos no Brasil, propor uma tradução para o termo e fazer uma breve revisão sobre o tema.
    UNASSIGNED: Foi enviada uma pesquisa, por meio de mensagem eletrônica, para diversos radiologistas de todo o Brasil, questionando sobre a familiarização com o termo, qual tradução em português utilizam e se usam os critérios propostos pela diretriz da Sociedade Fleischner.
    UNASSIGNED: Foram recebidas 163 respostas de todas as regiões do Brasil e a grande maioria dos radiologistas respondeu estar familiarizado com o termo interstitial lung abnormalities (88%), mas houve grande variação em relação ao termo utilizado como tradução para o português.
    UNASSIGNED: Sugerimos a padronização do termo “anormalidades pulmonares intersticiais”, a fim de uniformizar os relatórios radiológicos e difundir esta entidade no País.
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  • 文章类型: Journal Article
    背景:本研究旨在通过在三维(3D)空间中使用几何分析,定量揭示径向探头支气管内超声(R-EBUS)期间气道导航失败的影响因素,并探讨临床上气道导航失败预测模型的可行性。
    方法:我们回顾性分析了2017年1月至2018年12月期间接受R-EBUS检查的患者。使用由开源python库构建的内部软件分析几何量化,包括血管建模工具包(http://www.vmtk.org),简单的洞察工具包(https://sitk.org),和sci-kit图像(https://scikit-image.org)。我们使用基于机器学习的方法来探索这些重要因素的效用。
    结果:在符合分析条件的491名患者中(平均年龄,65岁+/-11[标准偏差];274名男性),目标病变在434例达到,57例未达到.根据倾向评分,失败组的27例患者与成功组的27例患者进行匹配。目标分支处的分叉角,最后一部分的最小直径,末段曲率是气道导航失败最显著和最稳定的因素。支持向量机能够预测气道导航失效,平均曲线下面积为0.803。
    结论:3D空间中的几何分析显示,在R-EBUS期间,较大的分叉角和最接近病变的支气管的狭窄曲折结构与气道导航失败有关。使用定量计算机断层扫描扫描成像开发的模型显示了预测气道导航失败的潜力。
    BACKGROUND: This study aimed to quantitatively reveal contributing factors to airway navigation failure during radial probe endobronchial ultrasound (R-EBUS) by using geometric analysis in a three-dimensional (3D) space and to investigate the clinical feasibility of prediction models for airway navigation failure.
    METHODS: We retrospectively reviewed patients who underwent R-EBUS between January 2017 and December 2018. Geometric quantification was analyzed using in-house software built with open-source python libraries including the Vascular Modeling Toolkit ( http://www.vmtk.org ), simple insight toolkit ( https://sitk.org ), and sci-kit image ( https://scikit-image.org ). We used a machine learning-based approach to explore the utility of these significant factors.
    RESULTS: Of the 491 patients who were eligible for analysis (mean age, 65 years +/- 11 [standard deviation]; 274 men), the target lesion was reached in 434 and was not reached in 57. Twenty-seven patients in the failure group were matched with 27 patients in the success group based on propensity scores. Bifurcation angle at the target branch, the least diameter of the last section, and the curvature of the last section are the most significant and stable factors for airway navigation failure. The support vector machine can predict airway navigation failure with an average area under the curve of 0.803.
    CONCLUSIONS: Geometric analysis in 3D space revealed that a large bifurcation angle and a narrow and tortuous structure of the closest bronchus from the lesion are associated with airway navigation failure during R-EBUS. The models developed using quantitative computer tomography scan imaging show the potential to predict airway navigation failure.
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  • 文章类型: Journal Article
    构建并验证计算机断层扫描(CT)影像组学模型,以区分肺神经内分泌肿瘤(LNEN)和肺腺癌(LADC),表现为外周实性结节(PSN),以帮助早期临床决策。
    从2016年6月至2023年7月,共有445例经病理证实为LNEN和LADC的患者从五个医疗中心回顾性纳入。将这些患者分为训练集(n=316;158LNEN)和外部测试集(n=129;43LNEN),前者包括交叉验证(CV)训练集和使用十倍CV的CV测试集。支持向量机(SVM)分类器用于开发语义,影像组学和合并模型。通过受试者工作特征曲线下面积(AUC)评估诊断性能,并通过Delong检验进行比较。收集术前神经元特异性烯醇化酶(NSE)水平作为临床预测因子。
    在训练集中,影像组学模型(0.878[95%CI:0.836,0.915])和合并模型(0.884[95%CI:0.844,0.919])的AUC显著优于语义模型(0.718[95%CI:0.663,0.769],p均<.001)。在外部测试集中,影像组学模型的AUC(0.787[95%CI:0.696,0.871]),合并模型(0.807[95CI:0.720,0.889])和语义模型(0.729[95%CI:0.631,0.811])无统计学差异。在训练集(85.3%vs20.0%;p<.001)和外部测试集(88.9%vs40.7%;p=.002)中,影像组学模型的灵敏度优于NSE。
    CT影像组学模型可以是非侵入性的,有效和灵敏地预测LNEN和LADC作为PSN,以帮助选择治疗策略。
    UNASSIGNED: To construct and validate a computed tomography (CT) radiomics model for differentiating lung neuroendocrine neoplasm (LNEN) from lung adenocarcinoma (LADC) manifesting as a peripheral solid nodule (PSN) to aid in early clinical decision-making.
    UNASSIGNED: A total of 445 patients with pathologically confirmed LNEN and LADC from June 2016 to July 2023 were retrospectively included from five medical centers. Those patients were split into the training set (n = 316; 158 LNEN) and external test set (n = 129; 43 LNEN), the former including the cross-validation (CV) training set and CV test set using ten-fold CV. The support vector machine (SVM) classifier was used to develop the semantic, radiomics and merged models. The diagnostic performances were evaluated by the area under the receiver operating characteristic curve (AUC) and compared by Delong test. Preoperative neuron-specific enolase (NSE) levels were collected as a clinical predictor.
    UNASSIGNED: In the training set, the AUCs of the radiomics model (0.878 [95% CI: 0.836, 0.915]) and merged model (0.884 [95% CI: 0.844, 0.919]) significantly outperformed the semantic model (0.718 [95% CI: 0.663, 0.769], p both<.001). In the external test set, the AUCs of the radiomics model (0.787 [95% CI: 0.696, 0.871]), merged model (0.807 [95%CI: 0.720, 0.889]) and semantic model (0.729 [95% CI: 0.631, 0.811]) did not exhibit statistical differences. The radiomics model outperformed NSE in sensitivity in the training set (85.3% vs 20.0%; p <.001) and external test set (88.9% vs 40.7%; p = .002).
    UNASSIGNED: The CT radiomics model could non-invasively, effectively and sensitively predict LNEN and LADC presenting as a PSN to assist in treatment strategy selection.
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