Autrusseau Pierre-Alexis, Labani Aïssam, De Marini Pierre, Leyendecker Pierre, Hintzpeter Cédric, Ortlieb Anne-Claire, Calhoun Michael, Goldberg Ilya, Roy Catherine, Ohana Mickael
Department of Diagnostic Imaging (Radio B), Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
Department of Diagnostic Imaging (Radio B), Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
Diagn Interv Imaging. 2021 Apr;102(4):233-239. doi: 10.1016/j.diii.2021.01.010. Epub 2021 Feb 11.
The purpose of this study was to retrospectively evaluate the quantitative and qualitative intrapatient concordance of pulmonary nodule risk assessment by commercially available radiomics software between full-dose (FD) chest-CT and ultra-low-dose (ULD) chest CT.
Between July 2013 and September 2015, 68 patients (52 men and16 women; mean age, 65.5±10.6 [SD] years; range: 35-87 years) with lung nodules≥5mm and<30mm who underwent the same day FD chest CT (helical acquisition; 120kV; automated tube current modulation) and ULD chest CT (helical acquisition; 135kV; 10mA fixed) were retrospectively included. Each nodule on each acquisition was assessed by a commercial radiomics software providing a similarity malignancy index (mSI), classifying it as "benign-like" (mSI<0.1); "malignant-like" (mSI>0.9) or "undetermined" (0.1≤mSI≤0.9). Intrapatient qualitative agreement was evaluated with weighted Cohen-Kappa test and quantitative agreement with intraclass correlation coefficient (ICC).
Ninety-nine lung nodules with a mean size of 9.14±4.3 (SD) mm (range: 5-25mm) in 68 patients (mean 1.46 nodule per patient; range: 1-5) were assessed; mean mSI was 0.429±0.331 (SD) (range: 0.001-1) with FD chest CT (22/99 [22%] "benign-like", 67/99 [68%] "undetermined" and 10/99 [10%] "malignant-like") and mean mSI was 0.487±0.344 (SD) (range: 0.002-1) with ULD chest CT (20/99 [20%] "benign-like", 59/99 [60%] "undetermined" and 20/99 [20%] "malignant-like"). Qualitative and quantitative agreement of FD chest CT with ULD chest CT were "good" with Kappa value of 0.60 (95% CI: 0.46-0.74) and ICC of 0.82 (95% CI: 0.73-0.87), respectively.
A good agreement in malignancy similarity index can be obtained between ULD chest CT and FD chest CT using radiomics software. However, further studies must be done with more case material to confirm our results and elucidate the diagnostic capabilities of radiomics software using ULD chest CT for lung nodule characterization by comparison with FD chest CT.
本研究的目的是回顾性评估商用放射组学软件在全剂量（FD）胸部CT和超低剂量（ULD）胸部CT之间对肺结节风险评估的患者内定量和定性一致性。
回顾性纳入2013年7月至2015年9月期间68例（52例男性和16例女性；平均年龄65.5±10.6[标准差]岁；范围：35 - 87岁）肺结节≥5mm且<30mm的患者，这些患者在同一天接受了FD胸部CT（螺旋扫描；120kV；自动管电流调制）和ULD胸部CT（螺旋扫描；135kV；10mA固定）检查。通过提供相似性恶性指数（mSI）的商用放射组学软件对每次扫描中的每个结节进行评估，将其分类为“良性样”（mSI<0.1）；“恶性样”（mSI>0.9）或“不确定”（0.1≤mSI≤0.9）。采用加权Cohen-Kappa检验评估患者内定性一致性，采用组内相关系数（ICC）评估定量一致性。
评估了68例患者中的99个肺结节，平均大小为9.14±4.3（标准差）mm（范围：5 - 25mm）（平均每位患者1.46个结节；范围：1 - 5个）；FD胸部CT的平均mSI为0.429±0.331（标准差）（范围：0.001 - 1）（22/99[22%]为“良性样”，67/99[68%]为“不确定”，10/99[10%]为“恶性样”），ULD胸部CT的平均mSI为0.487±0.344（标准差）（范围：0.002 - 1）（20/99[20%]为“良性样”，59/99[60%]为“不确定”，20/99[20%]为“恶性样”）。FD胸部CT与ULD胸部CT的定性和定量一致性均为“良好”，Kappa值为0.60（95%CI：0.46 - 0.74），ICC为0.82（95%CI：0.73 - 0.87）。
使用放射组学软件，ULD胸部CT和FD胸部CT在恶性相似性指数方面具有良好的一致性。然而，必须使用更多病例材料进行进一步研究，以证实我们的结果，并通过与FD胸部CT比较阐明使用ULD胸部CT的放射组学软件对肺结节特征进行诊断的能力。
