Tao Xue-Min, Fang Rui, Wu Chong-Chong, Zhang Chi, Zhang Rong-Guo, Yu Peng-Xin, Zhao Shao-Hong
Medical School of Chinese PLA,Beijing 100853,China.
Department of Radiology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2020 Aug 30;42(4):477-484. doi: 10.3881/j.issn.1000-503X.11693.
To make a preliminary pathological classification of lung adenocarcinoma with pure ground glass nodules(pGGN)on CT by using a deep learning model. CT images and pathological data of 219 patients(240 lesions in total)with pGGN on CT and pathologically confirmed adenocarcinoma were collected.According to pathological subtypes,the lesions were divided into non-invasive lung adenocarcinoma group(which included atypical adenomatous hyperplasia and adenocarcinoma in situ and micro-invasive adenocarcinoma)and invasive lung adenocarcinoma group.First,the lesions were outlined and labeled by two young radiologists,and then the labeled data were randomly divided into two datasets:the training set(80%)and the test set(20%).The prediction Results of deep learning were compared with those of two experienced radiologists by using the test dataset. The deep learning model achieved high performance in predicting the pathological types(non-invasive and invasive)of pGGN lung adenocarcinoma.The accuracy rate in pGGN diagnosis was 0.8330(95% =0.7016-0.9157)for of deep learning model,0.5000(95% =0.3639-0.6361)for expert 1,0.5625(95% =0.4227-0.6931)for expert 2,and 0.5417(95% =0.4029-0.6743)for both two experts.Thus,the accuracy of the deep learning model was significantly higher than those of the experienced radiologists(=0.002).The intra-observer agreements were good(Kappa values:0.939 and 0.799,respectively).The inter-observer agreement was general(Kappa value:0.667)(=0.000). The deep learning model showed better performance in predicting the pathological types of pGGN lung adenocarcinoma compared with experienced radiologists.
利用深度学习模型对CT上表现为纯磨玻璃结节(pGGN)的肺腺癌进行初步病理分类。收集了219例CT表现为pGGN且病理确诊为腺癌患者的CT图像和病理数据(共240个病灶)。根据病理亚型,将病灶分为非侵袭性肺腺癌组(包括非典型腺瘤样增生、原位腺癌和微浸润腺癌)和侵袭性肺腺癌组。首先,由两位年轻放射科医师对病灶进行勾勒和标注,然后将标注后的数据随机分为两个数据集:训练集(80%)和测试集(20%)。利用测试数据集将深度学习的预测结果与两位经验丰富的放射科医师的结果进行比较。深度学习模型在预测pGGN肺腺癌的病理类型(非侵袭性和侵袭性)方面表现出高性能。深度学习模型在pGGN诊断中的准确率为0.8330(95%可信区间=0.7016 - 0.9157),专家1为0.5000(95%可信区间=0.3639 - 0.6361),专家2为0.5625(95%可信区间=0.4227 - 0.6931),两位专家联合为0.5417(95%可信区间=0.4029 - 0.6743)。因此,深度学习模型的准确率显著高于经验丰富的放射科医师(P = 0.002)。观察者内一致性良好(Kappa值分别为0.939和0.799)。观察者间一致性一般(Kappa值:0.667)(P = 0.000)。与经验丰富的放射科医师相比,深度学习模型在预测pGGN肺腺癌的病理类型方面表现更佳。