Yao Huang , Xiaoxia Wang , Ying Cao , Mengfei Li , Lan Li , Huifang Chen , Sun Tang , Xiaosong Lan , Fujie Jiang , Jiuquan Zhang
{"title":"Multiparametric MRI model to predict molecular subtypes of breast cancer using Shapley additive explanations interpretability analysis","authors":"Yao Huang , Xiaoxia Wang , Ying Cao , Mengfei Li , Lan Li , Huifang Chen , Sun Tang , Xiaosong Lan , Fujie Jiang , Jiuquan Zhang","doi":"10.1016/j.diii.2024.01.004","DOIUrl":"10.1016/j.diii.2024.01.004","url":null,"abstract":"<div><h3>Purpose</h3><p>The purpose of this study was to assess the predictive performance of multiparametric magnetic resonance imaging (MRI) for molecular subtypes and interpret features using SHapley Additive exPlanations (SHAP) analysis.</p></div><div><h3>Material and methods</h3><p>Patients with breast cancer who underwent pre-treatment MRI (including ultrafast dynamic contrast-enhanced MRI, magnetic resonance spectroscopy, diffusion kurtosis imaging and intravoxel incoherent motion) were recruited between February 2019 and January 2022. Thirteen semantic and thirteen multiparametric features were collected and the key features were selected to develop machine-learning models for predicting molecular subtypes of breast cancers (luminal A, luminal B, triple-negative and HER2-enriched) by using stepwise logistic regression. Semantic model and multiparametric model were built and compared based on five machine-learning classifiers. Model decision-making was interpreted using SHAP analysis.</p></div><div><h3>Results</h3><p>A total of 188 women (mean age, 53 ± 11 [standard deviation] years; age range: 25–75 years) were enrolled and further divided into training cohort (131 women) and validation cohort (57 women). XGBoost demonstrated good predictive performance among five machine-learning classifiers. Within the validation cohort, the areas under the receiver operating characteristic curves (AUCs) for the semantic models ranged from 0.693 (95% confidence interval [CI]: 0.478–0.839) for HER2-enriched subtype to 0.764 (95% CI: 0.681–0.908) for luminal A subtype, inferior to multiparametric models that yielded AUCs ranging from 0.771 (95% CI: 0.630–0.888) for HER2-enriched subtype to 0.857 (95% CI: 0.717–0.957) for triple-negative subtype. The AUCs between the semantic and the multiparametric models did not show significant differences (<em>P</em> range: 0.217–0.640). SHAP analysis revealed that lower iAUC, higher kurtosis, lower D*, and lower kurtosis were distinctive features for luminal A, luminal B, triple-negative breast cancer, and HER2-enriched subtypes, respectively.</p></div><div><h3>Conclusion</h3><p>Multiparametric MRI is superior to semantic models to effectively predict the molecular subtypes of breast cancer.</p></div>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139561841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Grégoire Martin de Frémont , Alessandra Monaya , Guillaume Chassagnon , Samir Bouam , Emma Canniff , Pascal Cohen , Marion Casadevall , Luc Mouthon , Véronique Le Guern , Marie-Pierre Revel
{"title":"Lung fibrosis is uncommon in primary Sjögren's disease: A retrospective analysis of computed tomography features in 77 patients","authors":"Grégoire Martin de Frémont , Alessandra Monaya , Guillaume Chassagnon , Samir Bouam , Emma Canniff , Pascal Cohen , Marion Casadevall , Luc Mouthon , Véronique Le Guern , Marie-Pierre Revel","doi":"10.1016/j.diii.2024.01.003","DOIUrl":"10.1016/j.diii.2024.01.003","url":null,"abstract":"<div><h3>Purpose</h3><p>The purpose of this study was to describe lung abnormalities observed on computed tomography (CT) in patients meeting the 2016 American College of Rheumatology/European League Against Rheumatism (EULAR) classification criteria for primary Sjögren's disease (pSD).</p></div><div><h3>Materials and methods</h3><p>All patients with pSD seen between January 2009 and December 2020 in the day care centre of our National Reference Center for rare systemic autoimmune diseases, who had at least one chest CT examination available for review and for whom the cumulative EULAR Sjögren's Syndrome Disease Activity Index (cumESSDAI) could be calculated were retrospectively evaluated. CT examinations were reviewed, together with clinical symptoms and pulmonary functional results.</p></div><div><h3>Results</h3><p>Seventy-seven patients (73 women, four men) with a median age of 51 years at pSD diagnosis (age range: 17–79 years), a median follow-up time of 6 years and a median cumESSDAI of 7 were included. Sixty-six patients (86%) had anti-SSA antibodies. Thirty-three patients (33/77; 43%) had respiratory symptoms, without significant alteration in pulmonary function tests. Forty patients (40/77; 52%) had abnormal lung CT findings of whom almost half of them had no respiratory symptoms. Abnormalities on chest CT were more frequently observed in patients with anti-SSA positivity and a history of lymphoma. Air cysts (28/77; 36%) and mosaic perfusion (35/77; 35%) were the predominant abnormalities, whereas lung fibrosis was observed in five patients (5/77; 6%).</p></div><div><h3>Conclusion</h3><p>More than half of patients with pSD have abnormal CT findings, mainly air cysts and mosaic perfusion, indicative of small airways disease, whereas lung fibrosis is rare, observed in less than 10% of such patients.</p></div>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Breast cancer molecular subtype prediction: Improving interpretability of complex machine-learning models based on multiparametric-MRI features using SHapley Additive exPlanations (SHAP) methodology","authors":"Amandine Crombé, Masako Kataoka","doi":"10.1016/j.diii.2024.01.008","DOIUrl":"10.1016/j.diii.2024.01.008","url":null,"abstract":"","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joël Greffier, D. Dabli, S. Faby, Maxime Pastor, Cédric Croisille, Fabien de Oliveira, Julien Erath, J. Beregi
{"title":"Abdominal image quality and dose reduction with energy-integrating or photon-counting detectors dual-source CT: A phantom study.","authors":"Joël Greffier, D. Dabli, S. Faby, Maxime Pastor, Cédric Croisille, Fabien de Oliveira, Julien Erath, J. Beregi","doi":"10.1016/j.diii.2024.05.002","DOIUrl":"https://doi.org/10.1016/j.diii.2024.05.002","url":null,"abstract":"","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141052625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pedram Keshavarz , Sara Bagherieh , Seyed Ali Nabipoorashrafi , Hamid Chalian , Amir Ali Rahsepar , Grace Hyun J. Kim , Cameron Hassani , Steven S. Raman , Arash Bedayat
{"title":"ChatGPT in radiology: A systematic review of performance, pitfalls, and future perspectives","authors":"Pedram Keshavarz , Sara Bagherieh , Seyed Ali Nabipoorashrafi , Hamid Chalian , Amir Ali Rahsepar , Grace Hyun J. Kim , Cameron Hassani , Steven S. Raman , Arash Bedayat","doi":"10.1016/j.diii.2024.04.003","DOIUrl":"10.1016/j.diii.2024.04.003","url":null,"abstract":"<div><h3>Purpose</h3><p>The purpose of this study was to systematically review the reported performances of ChatGPT, identify potential limitations, and explore future directions for its integration, optimization, and ethical considerations in radiology applications.</p></div><div><h3>Materials and methods</h3><p>After a comprehensive review of PubMed, Web of Science, Embase, and Google Scholar databases, a cohort of published studies was identified up to January 1, 2024, utilizing ChatGPT for clinical radiology applications.</p></div><div><h3>Results</h3><p>Out of 861 studies derived, 44 studies evaluated the performance of ChatGPT; among these, 37 (37/44; 84.1%) demonstrated high performance, and seven (7/44; 15.9%) indicated it had a lower performance in providing information on diagnosis and clinical decision support (6/44; 13.6%) and patient communication and educational content (1/44; 2.3%). Twenty-four (24/44; 54.5%) studies reported the proportion of ChatGPT's performance. Among these, 19 (19/24; 79.2%) studies recorded a median accuracy of 70.5%, and in five (5/24; 20.8%) studies, there was a median agreement of 83.6% between ChatGPT outcomes and reference standards [radiologists’ decision or guidelines], generally confirming ChatGPT's high accuracy in these studies. Eleven studies compared two recent ChatGPT versions, and in ten (10/11; 90.9%), ChatGPTv4 outperformed v3.5, showing notable enhancements in addressing higher-order thinking questions, better comprehension of radiology terms, and improved accuracy in describing images. Risks and concerns about using ChatGPT included biased responses, limited originality, and the potential for inaccurate information leading to misinformation, hallucinations, improper citations and fake references, cybersecurity vulnerabilities, and patient privacy risks.</p></div><div><h3>Conclusion</h3><p>Although ChatGPT's effectiveness has been shown in 84.1% of radiology studies, there are still multiple pitfalls and limitations to address. It is too soon to confirm its complete proficiency and accuracy, and more extensive multicenter studies utilizing diverse datasets and pre-training techniques are required to verify ChatGPT's role in radiology.</p></div>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211568424001050/pdfft?md5=c220d60df18e8b0b15148619195f5a41&pid=1-s2.0-S2211568424001050-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ultra-low dose chest CT for the diagnosis of pulmonary arteriovenous malformation in patients with hereditary hemorrhagic telangiectasia","authors":"","doi":"10.1016/j.diii.2024.03.006","DOIUrl":"10.1016/j.diii.2024.03.006","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to compare ultra-low dose (ULD) and standard low-dose (SLD) chest computed tomography (CT) in terms of radiation exposure, image quality and diagnostic value for diagnosing pulmonary arteriovenous malformation (AVM) in patients with hereditary hemorrhagic telangiectasia (HHT).</div></div><div><h3>Materials and methods</h3><div>In this prospective board-approved study consecutive patients with HHT referred to a reference center for screening and/or follow-up chest CT examination were prospectively included from December 2020 to January 2022. Patients underwent two consecutive non-contrast chest CTs without dose modulation (<em>i.e.</em>, one ULD protocol [80 kVp or 100 kVp, CTDIvol of 0.3 mGy or 0.6 mGy] and one SLD protocol [140 kVp, CTDIvol of 1.3 mGy]). Objective image noises measured at the level of tracheal carina were compared between the two protocols. Overall image quality and diagnostic confidence were scored on a 4-point Likert scale (1 = insufficient to 4 = excellent). Sensitivity, specificity, positive predictive value and negative predictive value of ULD CT for diagnosing pulmonary AVM with a feeding artery of over 2 mm in diameter were calculated along with their 95% confidence intervals (CI) using SLD images as the standard of reference.</div></div><div><h3>Results</h3><div>A total of 44 consecutive patients with HHT (31 women; mean age, 42 ± 16 [standard deviation (SD)] years; body mass index, 23.2 ± 4.5 [SD] kg/m<sup>2</sup>) were included. Thirty-four pulmonary AVMs with a feeding artery of over 2 mm in diameter were found with SLD images versus 35 with ULD images. Sensitivity, specificity, predictive positive value, and predictive negative value of ULD CT for the diagnosis of PAVM were 100% (34/34; 95% CI: 90–100), 96% (18/19; 95% CI: 74–100), 97% (34/35; 95% CI: 85–100) and 100% (18/18; 95% CI: 81–100), respectively. A significant difference in diagnostic confidence scores was found between ULD (3.8 ± 0.4 [SD]) and SLD (3.9 ± 0.1 [SD]) CT images (<em>P</em> = 0.03). No differences in overall image quality scores were found between ULD CT examinations (3.9 ± 0.2 [SD]) and SLD (4 ± 0 [SD]) CT examinations (<em>P</em> = 0.77). Effective radiation dose decreased significantly by 78.8% with ULD protocol, with no significant differences in noise values between ULD CT images (16.7 ± 5.0 [SD] HU) and SLD images (17.7 ± 6.6 [SD] HU) (<em>P</em> = 0.07).</div></div><div><h3>Conclusion</h3><div>ULD chest CT provides 100% sensitivity and 96% specificity for the diagnosis of treatable pulmonary AVM with a feeding artery of over 2 mm in diameter, leading to a 78.8% dose-saving compared with a standard low-dose protocol.</div></div>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140773146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Differentiation between adrenocortical carcinoma and lipid-poor adrenal adenoma using a multiparametric MRI-based diagnostic algorithm","authors":"","doi":"10.1016/j.diii.2024.03.005","DOIUrl":"10.1016/j.diii.2024.03.005","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to evaluate the capabilities of multiparametric magnetic resonance imaging (MRI) in differentiating between lipid-poor adrenal adenoma (LPAA) and adrenocortical carcinoma (ACC).</div></div><div><h3>Materials and methods</h3><div>Patients of two centers who underwent surgical resection of LPAA or ACC after multiparametric MRI were retrospectively included. A training cohort was used to build a diagnostic algorithm obtained through recursive partitioning based on multiparametric MRI variables, including apparent diffusion coefficient and chemical shift signal ratio (<em>i.e.</em>, tumor signal intensity index). The diagnostic performances of the multiparametric MRI-based algorithm were evaluated using a validation cohort, alone first and then in association with adrenal tumor size using a cut-off of 4 cm. Performances of the diagnostic algorithm for the diagnosis of ACC <em>vs.</em> LPAA were calculated using pathology as the reference standard.</div></div><div><h3>Results</h3><div>Fifty-four patients (27 with LPAA and 27 with ACC; 37 women; mean age, 48.5 ± 13.3 [standard deviation (SD)] years) were used as the training cohort and 61 patients (24 with LPAA and 37 with ACC; 47 women; mean age, 49 ± 11.7 [SD] years) were used as the validation cohort. In the validation cohort, the diagnostic algorithm yielded best accuracy for the diagnosis of ACC <em>vs.</em> LPAA (75%; 46/61; 95% CI: 55–88) when used without lesion size. Best sensitivity was obtained with the association of the diagnostic algorithm with tumor size (96%; 23/24; 95% CI: 80–99). Best specificity was obtained with the diagnostic algorithm used alone (76%; 28/37; 95% CI: 60–87).</div></div><div><h3>Conclusion</h3><div>A multiparametric MRI-based diagnostic algorithm that includes apparent diffusion coefficient and tumor signal intensity index helps discriminate between ACC and LPAA with high degrees of specificity and accuracy. The association of the multiparametric MRI-based diagnostic algorithm with adrenal lesion size helps maximize the sensitivity of multiparametric MRI for the diagnosis of ACC.</div></div>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of two deep-learning image reconstruction algorithms on cardiac CT images: A phantom study","authors":"Joël Greffier , Maxime Pastor , Salim Si-Mohamed , Cynthia Goutain-Majorel , Aude Peudon-Balas , Mourad Zoubir Bensalah , Julien Frandon , Jean-Paul Beregi , Djamel Dabli","doi":"10.1016/j.diii.2023.10.004","DOIUrl":"10.1016/j.diii.2023.10.004","url":null,"abstract":"<div><h3>Purpose</h3><p>The purpose of this study was to compare the performance of Precise IQ Engine (PIQE) and Advanced intelligent Clear-IQ Engine (AiCE) algorithms on image-quality according to the dose level in a cardiac computed tomography (CT) protocol.</p></div><div><h3>Materials and methods</h3><p>Acquisitions were performed using the CT ACR 464 phantom at three dose levels (volume CT dose indexes: 7.1/5.2/3.1 mGy) using a prospective cardiac CT protocol. Raw data were reconstructed using the three levels of AiCE and PIQE (Mild, Standard and Strong). The noise power spectrum (NPS) and task-based transfer function (TTF) for bone and acrylic inserts were computed. The detectability index (d’) was computed to model the detectability of the coronary lumen (350 Hounsfield units and 4-mm diameter) and non-calcified plaque (40 Hounsfield units and 2-mm diameter).</p></div><div><h3>Results</h3><p>Noise magnitude values were lower with PIQE than with AiCE (−13.4 ± 6.0 [standard deviation (SD)] % for Mild, -20.4 ± 4.0 [SD] % for Standard and -32.6 ± 2.6 [SD] % for Strong levels). The average NPS spatial frequencies shifted towards higher frequencies with PIQE than with AiCE (21.9 ± 3.5 [SD] % for Mild, 20.1 ± 3.0 [SD] % for Standard and 12.5 ± 3.5 [SD] % for Strong levels). The TTF values at fifty percent (f<sub>5</sub><sub>0</sub>) values shifted towards higher frequencies with PIQE than with AiCE for acrylic inserts but, for bone inserts, f<sub>50</sub> values were found to be close. Whatever the dose and DLR level, d’ values of both simulated cardiac lesions were higher with PIQE than with AiCE. For the simulated coronary lumen, d’ values were better by 35.1 ± 9.3 (SD) % on average for all dose levels for Mild, 43.2 ± 5.0 (SD) % for Standard, and 62.6 ± 1.2 (SD) % for Strong levels.</p></div><div><h3>Conclusion</h3><p>Compared to AiCE, PIQE reduced noise, improved spatial resolution, noise texture and detectability of simulated cardiac lesions. PIQE seems to have a greater potential for dose reduction in cardiac CT acquisition.</p></div>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72211429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}