Wang Xiang, Li Qingchu, Cai Jiali, Wang Wei, Xu Peng, Zhang Yiqian, Fang Qu, Fu Chicheng, Fan Li, Xiao Yi, Liu Shiyuan
Department of Radiology, Changzheng Hospital of the Second Military Medical University, Shanghai, China.
Shanghai Aitrox Technology Corporation Limited, Shanghai, China.
Transl Lung Cancer Res. 2020 Aug;9(4):1397-1406. doi: 10.21037/tlcr-20-370.
BACKGROUND: Due to different treatment method and prognosis of different subtypes of lung adenocarcinomas appearing as ground-glass nodules (GGNs) on computed tomography (CT) scan, it is important to classify invasive adenocarcinomas from non-invasive adenocarcinomas. The purpose of this paper is to build and evaluate the performance of deep learning networks on the differentiation the invasiveness of lung adenocarcinoma appearing as GGNs. METHODS: This retrospective study included 886 GGNs from 794 pathological confirmed patients with lung adenocarcinoma for training and testing the proposed networks. Three deep learning networks, namely XimaNet (deep learning-based classification model), XimaSharp (classification and nodule segmentation model), and Deep-RadNet (deep learning and radiomics combined classification model, i.e., deep radiomics) were built. Three classification tasks, namely task 1: classification of AAH/AIS and MIA, task 2: classification of MIA and IAC, and task 3: classification of non-invasive adenocarcinomas and invasive adenocarcinomas (AAH/AIS&MIA and IAC) were conducted to evaluate the model performance. The Z-test was used to compare the model performance. RESULTS: The AUC for classification of AAH/AIS with MIA were 0.891, 0.841 and 0.779 for Deep-RadNet, XimaNet and XimaSharp respectively. The AUC for classification of MIA with IAC were 0.889, 0.785 and 0.778 for three networks and AUC for classification of AAH/AIS&MIA with IAC were 0.941, 0.892 and 0.827 respectively. The performance of deep_RadNet was better than the other two models with the Z-test (P<0.05). CONCLUSIONS: Deep-RadNet with the visual heat map could evaluate the invasiveness of GGNs accurately and intuitively, providing a theoretical basis for individualized and accurate medical treatment of patients with GGNs.
背景:由于计算机断层扫描(CT)上表现为磨玻璃结节(GGN)的不同亚型肺腺癌的治疗方法和预后不同,区分浸润性腺癌和非浸润性腺癌很重要。本文的目的是构建并评估深度学习网络在鉴别表现为GGN的肺腺癌浸润性方面的性能。 方法:这项回顾性研究纳入了794例经病理确诊的肺腺癌患者的886个GGN,用于训练和测试所提出的网络。构建了三个深度学习网络,即西玛网(基于深度学习的分类模型)、西玛锐(分类和结节分割模型)和深度放射网(深度学习与放射组学相结合的分类模型,即深度放射组学)。进行了三项分类任务,即任务1:非典型腺瘤样增生/原位腺癌(AAH/AIS)与微浸润腺癌(MIA)的分类,任务2:MIA与浸润性腺癌(IAC)的分类,任务3:非浸润性腺癌(AAH/AIS&MIA)与浸润性腺癌(IAC)的分类,以评估模型性能。采用Z检验比较模型性能。 结果:深度放射网、西玛网和西玛锐对AAH/AIS与MIA分类的曲线下面积(AUC)分别为0.891、0.841和0.779。三个网络对MIA与IAC分类的AUC分别为0.889、0.785和0.778,对AAH/AIS&MIA与IAC分类的AUC分别为0.941、0.892和0.827。经Z检验,深度放射网的性能优于其他两个模型(P<0.05)。 结论:带有可视化热图的深度放射网能够准确直观地评估GGN的浸润性,为GGN患者的个体化精准医疗提供理论依据。
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