肺结节的定量计算机断层扫描分类：二维和三维分析的初步比较
Quantitative Computed Tomography Classification of Lung Nodules: Initial Comparison of 2- and 3-Dimensional Analysis.
作者信息
Gierada David S, Politte David G, Zheng Jie, Schechtman Kenneth B, Whiting Bruce R, Smith Kirk E, Crabtree Traves, Kreisel Daniel, Krupnick Alexander S, Patterson G Alexander, Puri Varun, Meyers Bryan F
机构信息
From the *Mallinckrodt Institute of Radiology, the †Department of Biostatistics, and the ‡Division of Cardiothoracic Surgery, Washington University School of Medicine, Saint Louis, MO.
出版信息
J Comput Assist Tomogr. 2016 Jul-Aug;40(4):589-95. doi: 10.1097/RCT.0000000000000394.
OBJECTIVE
The aim of this study was to compare the performance of 2- (2D) and 3-dimensional (3D) quantitative computed tomography (CT) methods for classifying lung nodules as lung cancer, metastases, or benign.
METHODS
Using semiautomated software and computerized analysis, we analyzed more than 50 quantitative CT features of 96 solid nodules in 94 patients, in 2D from a single slice and in 3D from the entire nodule volume. Multivariable logistic regression was used to classify nodule types. Model performance was assessed by the area under the receiver operating characteristic curve (AUC) using leave-one-out cross-validation.
RESULTS
The AUC for distinguishing 53 primary lung cancers from 18 benign nodules and 25 metastases ranged from 0.79 to 0.83 and was not significantly different for 2D and 3D analyses (P = 0.29-0.78). Models distinguishing metastases from benign nodules were statistically significant only by 3D analysis (AUC = 0.84).
CONCLUSIONS
Three-dimensional CT methods did not improve discrimination of lung cancer, but may help distinguish benign nodules from metastases.
目的
本研究旨在比较二维（2D）和三维（3D）定量计算机断层扫描（CT）方法在将肺结节分类为肺癌、转移瘤或良性结节方面的性能。
方法
使用半自动软件和计算机分析，我们分析了94例患者中96个实性结节的50多个定量CT特征，2D分析采用单个层面，3D分析采用整个结节体积。多变量逻辑回归用于对结节类型进行分类。使用留一法交叉验证通过受试者操作特征曲线（AUC）下的面积评估模型性能。
结果
区分53例原发性肺癌与18个良性结节和25个转移瘤的AUC范围为0.79至0.83，2D和3D分析无显著差异（P = 0.29 - 0.78）。仅通过3D分析，区分转移瘤与良性结节的模型具有统计学意义（AUC = 0.84）。
结论
三维CT方法并未改善对肺癌的鉴别，但可能有助于区分良性结节与转移瘤。
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