Tang Min, Xie Qianrong, Wang Jiasi, Zhai Xiaoyu, Lin Hong, Zheng Xiaoxue, Wei Guoli, Tang Yan, Zeng Fanwei, Chu Yanpeng, Song Jianqiong, Cai Jianqiang, Zeng Fanxin
Department of Ultrasound Imaging, Dazhou Central Hospital, Dazhou, China.
Department of Clinical Research Center, Dazhou Central Hospital, Dazhou, China.
Front Oncol. 2020 Nov 12;10:578884. doi: 10.3389/fonc.2020.578884. eCollection 2020.
Worldwide, the incidence and mortality of lung cancer are at the highest levels, and the most lesions are located in the lung periphery. Despite extensive screening and diagnosis, the pathologic types of peripheral pulmonary lesions (PPLs) are difficult to diagnose by noninvasive examination. This study aimed to identify a novel index-time difference of arrival (TDOA)-to discriminate between benign inflammation and malignant PPLs.
Using contrast-enhanced ultrasound (CEUS), we retrospectively analyzed 96 patients with PPLs who had undergone biopsy to confirm the pathologic types. All data were collected from Dazhou Central Hospital between December 2012 and July 2019. The parameters of CEUS were analyzed by two assistant chief physicians of ultrasound diagnosis. Area under the receiver operating characteristic curve analysis, sensitivity, specificity, positive predictive value, and negative predictive value were calculated to assess the diagnostic ability of different indices.
We found that the TDOA significantly distinguished benign inflammation from malignant lesions. The TDOA was markedly increased in patients with malignant lesions than benign inflammation lesions ( < 0.001). Compared with conventional time-intensity curve (TIC) indices, TDOA showed high diagnostic accuracy (area under the curve = 0.894). Moreover, conventional diagnostic indices did not affect the diagnostic performance of TDOA by adjusting the receiver operating characteristic curve.
TDOA is feasible for the diagnosis of benign inflammation and malignant PPLs.
在全球范围内，肺癌的发病率和死亡率均处于最高水平，且大多数病灶位于肺外周。尽管进行了广泛的筛查和诊断，但通过非侵入性检查难以诊断外周肺部病变（PPL）的病理类型。本研究旨在确定一种新的指标——到达时间差（TDOA），以区分良性炎症和恶性PPL。
我们使用超声造影（CEUS），回顾性分析了96例接受活检以确诊病理类型的PPL患者。所有数据均收集自大竹中心医院2012年12月至2019年7月期间。由两位超声诊断副主任医师分析CEUS参数。计算受试者工作特征曲线下面积、敏感性、特异性、阳性预测值和阴性预测值，以评估不同指标的诊断能力。
我们发现TDOA能显著区分良性炎症和恶性病变。恶性病变患者的TDOA明显高于良性炎症病变患者（<0.001）。与传统时间-强度曲线（TIC）指标相比，TDOA显示出较高的诊断准确性（曲线下面积=0.894）。此外，通过调整受试者工作特征曲线，传统诊断指标并不影响TDOA的诊断性能。
TDOA在诊断良性炎症和恶性PPL方面是可行的。
