Kazantzi Alexandra, Costaridou Lena, Skiadopoulos Spyros, Korfiatis Panayiotis, Karahaliou Anna, Daoussis Dimitris, Andonopoulos Andreas, Kalogeropoulou Christina
Department of Radiology, School of Medicine, University of Patras, 26504, Patras, Greece.
J Digit Imaging. 2014 Jun;27(3):380-91. doi: 10.1007/s10278-013-9670-z.
In this study, the performance of a recently proposed computer-aided diagnosis (CAD) scheme in detection and 3D quantification of reticular and ground glass pattern extent in chest computed tomography of interstitial lung disease (ILD) patients is evaluated. CAD scheme performance was evaluated on a dataset of 37 volumetric chest scans, considering five representative axial anatomical levels per scan. CAD scheme reliability analysis was performed by estimating agreement (intraclass correlation coefficient, ICC) of automatically derived ILD pattern extent to semi-quantitative disease extent assessment in terms of 29-point rating scale provided by two expert radiologists. Receiver operating characteristic (ROC) analysis was employed to assess CAD scheme accuracy in ILD pattern detection in terms of area under ROC curve (A z ). Correlation of reticular and ground glass volumetric pattern extent to pulmonary function tests (PFTs) was also investigated. CAD scheme reliability was substantial for ILD extent (ICC = 0.809) and distinct reticular pattern extent (0.806) and moderate for distinct ground glass pattern extent (0.543), performing within inter-observer agreement. CAD scheme demonstrated high accuracy in detecting total ILD (A z = 0.950 ± 0.018), while accuracy in detecting distinct reticular and ground glass patterns was 0.920 ± 0.023 and 0.883 ± 0.024, respectively. Moderate and statistically significant negative correlation was found between reticular volumetric pattern extent and diffusing capacity, forced expiratory volume in 1 s, forced vital capacity, and total lung capacity (R = -0.581, -0.513, -0.494, and -0.446, respectively), similar to correlations found between radiologists' semi-quantitative ratings with PFTs. CAD-based quantification of disease extent is in agreement with radiologists' semi-quantitative assessment and correlates to specific PFTs, suggesting a potential imaging biomarker for ILD staging and management.
在本研究中，对最近提出的一种计算机辅助诊断（CAD）方案在间质性肺疾病（ILD）患者胸部计算机断层扫描中网状和磨玻璃影范围的检测及三维定量方面的性能进行了评估。在一个包含37例胸部容积扫描的数据集上评估CAD方案的性能，每个扫描考虑五个代表性的轴向解剖层面。通过估计自动得出的ILD影像范围与两位专家放射科医生根据29分评分量表进行的半定量疾病范围评估之间的一致性（组内相关系数，ICC），对CAD方案进行可靠性分析。采用受试者操作特征（ROC）分析，根据ROC曲线下面积（Az）评估CAD方案在ILD影像检测中的准确性。还研究了网状和磨玻璃容积影像范围与肺功能测试（PFT）之间的相关性。CAD方案在ILD范围（ICC = 0.809）和明显的网状影像范围（0.806）方面可靠性较高，在明显的磨玻璃影像范围方面可靠性中等（0.543），在观察者间一致性范围内。CAD方案在检测总ILD方面显示出较高的准确性（Az = 0.950 ± 0.018），而检测明显的网状和磨玻璃影像的准确性分别为0.920 ± 0.023和0.883 ± 0.024。在网状容积影像范围与弥散功能、一秒用力呼气容积、用力肺活量和肺总量之间发现了中度且具有统计学意义的负相关（R分别为 -0.581、-0.513、-0.494和 -0.446），这与放射科医生的半定量评分与PFT之间的相关性相似。基于CAD的疾病范围定量与放射科医生的半定量评估一致，且与特定的PFT相关，提示其可能成为ILD分期和管理的一种影像学生物标志物。
