Szabó Botond K, Wiberg Maria Kristoffersen, Boné Beata, Aspelin Peter
Division of Diagnostic Radiology, Center for Surgical Sciences, Karolinska Institute, Huddinge University Hospital, 141 86 Stockholm, Sweden.
Eur Radiol. 2004 Jul;14(7):1217-25. doi: 10.1007/s00330-004-2280-x. Epub 2004 Mar 18.
The discriminative ability of established diagnostic criteria for MRI of the breast is assessed, and their relative relevance using artificial neural networks (ANNs) is determined. A total of 89 women with 105 histopathologically verified breast lesions (73 invasive cancers, 2 in situ cancers, and 30 benign lesions) were included in this study. A T1-weighted 3D FLASH sequence was acquired before and seven times after the intravenous administration of gadopentetate dimeglumine at a dose of 0.2 mmol/kg body weight. ANN models were built to test the discriminative ability of kinetic, morphologic, and combined MR features. The subjects were randomly divided into two parts: a training set of 59 lesions and a verification set of 46 lesions. The training set was used for learning, and the performance of each model was evaluated on the verification set by measuring the area under the ROC curve (Az). An optimally minimized model was constructed using the most relevant input variables that were determined by the automatic relevance determination (ARD) method. ANN models were compared with the performance of a human reader. Margin type, time-to-peak enhancement, and washout ratio showed the highest discriminative ability among diagnostic criteria and comprised the minimized model. Compared with the expert radiologist (Az = 0.799), using the same prediction scale, the minimized ANN model performed best (Az = 0.771), followed by the best kinetic (Az = 0.743), the maximized (Az = 0.727), and the morphologic model (Az = 0.678). The performance of a neural network prediction model is comparable to that of an expert radiologist. A neurostatistical approach is preferred for the analysis of diagnostic criteria when many parameters are involved and complex nonlinear relationships exist in the data set.
评估了已确立的乳腺MRI诊断标准的鉴别能力,并使用人工神经网络(ANN)确定了它们的相对相关性。本研究共纳入89名患有105个经组织病理学证实的乳腺病变的女性(73例浸润性癌、2例原位癌和30例良性病变)。在静脉注射剂量为0.2 mmol/kg体重的钆喷酸葡胺之前和之后七次采集T1加权3D FLASH序列。建立ANN模型以测试动力学、形态学和联合MR特征的鉴别能力。受试者被随机分为两部分:59个病变的训练集和46个病变的验证集。训练集用于学习,每个模型的性能通过测量ROC曲线下面积(Az)在验证集上进行评估。使用自动相关性确定(ARD)方法确定的最相关输入变量构建了一个最优最小化模型。将ANN模型与人类读者的表现进行比较。边缘类型、峰值增强时间和洗脱率在诊断标准中显示出最高的鉴别能力,并构成了最小化模型。与专家放射科医生(Az = 0.799)相比,在相同的预测尺度下,最小化的ANN模型表现最佳(Az = 0.771),其次是最佳动力学模型(Az = 0.743)、最大化模型(Az = 0.727)和形态学模型(Az = 0.678)。神经网络预测模型的性能与专家放射科医生的性能相当。当数据集中涉及许多参数且存在复杂的非线性关系时,神经统计学方法更适合用于分析诊断标准。