肺结节计算机辅助检测系统在标准剂量和低剂量儿科 CT 扫描上的性能：个体内比较。

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

American Journal of Roentgenology Pub Date : 2024-10-09 DOI:10.2214/AJR.24.31972

Russell C Hardie, Andrew T Trout, Jonathan R Dillman, Barath N Narayanan, Aki A Tanimoto

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引用次数: 0

摘要

背景：在儿科 CT 中应用肺结节计算机辅助检测（CAD）系统时，由于图像噪声增加，可能会降低低剂量扫描的性能。目的：对肺结节计算机辅助检测系统进行个体内比较：在低剂量和标准剂量儿科胸部 CT 扫描中，对使用成人数据训练的两种 CAD 系统的肺结节检测性能进行个体内比较。方法这项回顾性研究纳入了 73 名患者（32 名女性，41 名男性；平均年龄 14.7 岁；年龄范围 4-20 岁），这些患者在 2018 年 11 月 30 日至 2020 年 8 月 31 日期间，作为早期前瞻性研究的一部分，在同一次就诊中接受了临床标准剂量和研究性低剂量胸部 CT 检查。经过研究员培训的儿科放射科医生对肺结节进行了注释，作为参考标准。两份 CT 扫描均使用两套公开提供的肺结节 CAD 系统进行处理，这两套系统之前曾使用成人数据进行过培训：FlyerScan 和人工智能医学开放网络 (MONAI)。在每次扫描出现两个假阳性的固定频率下，计算了系统对 3-30 毫米结节（n=247）的灵敏度。结果显示FlyerScan 对标准剂量扫描的检测灵敏度为 76.9%（190/247；95% CI：73.3-80.8%），对低剂量扫描的检测灵敏度为 66.8%（165/247；95% CI：62.6-71.5）。MONAI 在标准剂量扫描中的检测灵敏度为 67.6%（167/247，95% CI：61.5-72.1），在低剂量扫描中的检测灵敏度为 62.3%（154/247，95% CI：56.1-66.5%）。标准剂量扫描和低剂量扫描检测到的结节数量分别为：3 毫米结节 33 个对 24 个（FlyerScan），16 个对 13 个（MONAI）；4 毫米结节 46 个对 42 个（FlyerScan），39 个对 30 个（MONAI）；5 毫米结节 38 个对 33 个（FlyerScan），32 个对 31 个（MONAI）；6 毫米结节 27 个对 20 个（FlyerScan），24 个对 24 个（MONAI）。对于≥7毫米的结节，两种系统的标准剂量扫描和低剂量扫描的检测结果并不一致。结论：两种肺结节 CAD 系统对同一患者进行的低剂量儿科 CT 扫描与标准剂量扫描相比，灵敏度有所下降。在低剂量扫描中，小于 5 毫米的结节的检测率明显降低。临床影响：在使用低剂量 CT 方案和 CAD 系统帮助检测儿科患者肺部小结节时需要谨慎。

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Performance of Lung-Nodule Computer-Aided Detection Systems on Standard-Dose and Low-Dose Pediatric CT Scans: An Intraindividual Comparison.

Background: When applying lung-nodule computer-aided detection (CAD) systems for pediatric CT, performance may be degraded on low-dose scans due to increased image noise. Objective: To conduct an intraindividual comparison of the performance for lung nodule detection of two CAD systems trained using adult data between low-dose and standard-dose pediatric chest CT scans. Methods: This retrospective study included 73 patients (32 female, 41 male; mean age, 14.7 years; age range, 4-20 years) who underwent both clinical standard-dose and investigational low-dose chest CT examinations within the same encounter from November 30, 2018 to August 31, 2020 as part of an earlier prospective study. Fellowship-trained pediatric radiologists annotated lung nodules to serve as the reference standard. Both CT scans were processed using two publicly available lung-nodule CAD systems previously trained using adult data: FlyerScan and Medical Open Network for Artificial Intelligence (MONAI). The systems' sensitivities for nodules measuring 3-30 mm (n=247) were calculated when operating at a fixed frequency of two false-positives per scan. Results: FlyerScan exhibited detection sensitivities of 76.9% (190/247; 95% CI: 73.3-80.8%) on standard-dose scans and 66.8% (165/247; 95% CI: 62.6-71.5) on low-dose scans. MONAI exhibited detection sensitivities of 67.6% (167/247, 95% CI: 61.5-72.1) on standard-dose scans and 62.3% (154/247, 95% CI: 56.1-66.5%) on low-dose scans. The number of detected nodules for standard-dose versus low-dose scans for 3-mm nodules was 33 versus 24 (FlyerScan) and 16 versus 13 (MONAI), 4-mm nodules was 46 versus 42 (FlyerScan) and 39 versus 30 (MONAI), 5-mm nodules was 38 versus 33 (FlyerScan) and 32 versus 31 (MONAI), and 6-mm nodules was 27 versus 20 (FlyerScan) and 24 versus 24 (MONAI). For nodules measuring ≥7 mm, detection did not show a consistent pattern between standard-dose and low-dose scans for either system. Conclusions: Two lung-nodule CAD systems demonstrated decreased sensitivity on low-dose versus standard-dose pediatric CT scans performed in the same patients. The reduced detection at low dose was overall more pronounced for nodules measuring less than 5 mm. Clinical Impact: Caution is needed when using low-dose CT protocols in combination with CAD systems to help detect small lung nodules in pediatric patients.

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来源期刊

American Journal of Roentgenology 医学-核医学

CiteScore

12.80

自引率

4.00%

发文量

920

审稿时长

3 months

期刊介绍： Founded in 1907, the monthly American Journal of Roentgenology (AJR) is the world’s longest continuously published general radiology journal. AJR is recognized as among the specialty’s leading peer-reviewed journals and has a worldwide circulation of close to 25,000. The journal publishes clinically-oriented articles across all radiology subspecialties, seeking relevance to radiologists’ daily practice. The journal publishes hundreds of articles annually with a diverse range of formats, including original research, reviews, clinical perspectives, editorials, and other short reports. The journal engages its audience through a spectrum of social media and digital communication activities.