“如果我更换计算机辅助检测（CAD）系统，我会改变结节管理建议吗？”——不同CAD系统之间的体积偏差对病变管理的影响
"Will I change nodule management recommendations if I change my CAD system?"-impact of volumetric deviation between different CAD systems on lesion management.
作者信息
Peters Alan A, Christe Andreas, von Stackelberg Oyunbileg, Pohl Moritz, Kauczor Hans-Ulrich, Heußel Claus Peter, Wielpütz Mark O, Ebner Lukas
机构信息
Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 672, Heidelberg, Germany.
Translational Lung Research Center Heidelberg (TLRC), German Lung Research Center (DZL), Marsilius-Arkaden 130, 69120, Heidelberg, Germany.
出版信息
Eur Radiol. 2023 Aug;33(8):5568-5577. doi: 10.1007/s00330-023-09525-z. Epub 2023 Mar 10.
OBJECTIVES
To evaluate and compare the measurement accuracy of two different computer-aided diagnosis (CAD) systems regarding artificial pulmonary nodules and assess the clinical impact of volumetric inaccuracies in a phantom study.
METHODS
In this phantom study, 59 different phantom arrangements with 326 artificial nodules (178 solid, 148 ground-glass) were scanned at 80 kV, 100 kV, and 120 kV. Four different nodule diameters were used: 5 mm, 8 mm, 10 mm, and 12 mm. Scans were analyzed by a deep-learning (DL)-based CAD and a standard CAD system. Relative volumetric errors (RVE) of each system vs. ground truth and the relative volume difference (RVD) DL-based vs. standard CAD were calculated. The Bland-Altman method was used to define the limits of agreement (LOA). The hypothetical impact on LungRADS classification was assessed for both systems.
RESULTS
There was no difference between the three voltage groups regarding nodule volumetry. Regarding the solid nodules, the RVE of the 5-mm-, 8-mm-, 10-mm-, and 12-mm-size groups for the DL CAD/standard CAD were 12.2/2.8%, 1.3/ - 2.8%, - 3.6/1.5%, and - 12.2/ - 0.3%, respectively. The corresponding values for the ground-glass nodules (GGN) were 25.6%/81.0%, 9.0%/28.0%, 7.6/20.6%, and 6.8/21.2%. The mean RVD for solid nodules/GGN was 1.3/ - 15.2%. Regarding the LungRADS classification, 88.5% and 79.8% of all solid nodules were correctly assigned by the DL CAD and the standard CAD, respectively. 14.9% of the nodules were assigned differently between the systems.
CONCLUSIONS
Patient management may be affected by the volumetric inaccuracy of the CAD systems and hence demands supervision and/or manual correction by a radiologist.
KEY POINTS
• The DL-based CAD system was more accurate in the volumetry of GGN and less accurate regarding solid nodules than the standard CAD system. • Nodule size and attenuation have an effect on the measurement accuracy of both systems; tube voltage has no effect on measurement accuracy. • Measurement inaccuracies of CAD systems can have an impact on patient management, which demands supervision by radiologists.
目的
评估和比较两种不同的计算机辅助诊断（CAD）系统对人工肺结节的测量准确性，并在体模研究中评估体积测量误差的临床影响。
方法
在这项体模研究中，对59种不同的体模配置以及326个人工结节（178个实性结节、148个磨玻璃结节）分别在80 kV、100 kV和120 kV下进行扫描。使用了四种不同的结节直径：5 mm、8 mm、10 mm和12 mm。扫描结果由基于深度学习（DL）的CAD系统和标准CAD系统进行分析。计算每个系统相对于真实值的相对体积误差（RVE）以及基于DL的CAD系统与标准CAD系统之间的相对体积差异（RVD）。采用Bland-Altman方法确定一致性界限（LOA）。评估了两种系统对LungRADS分类的假设影响。
结果
三个电压组在结节体积测量方面没有差异。对于实性结节，DL CAD/标准CAD系统中5 mm、8 mm、10 mm和12 mm大小组的RVE分别为12.2%/2.8%、1.3%/-2.8%、-3.6%/1.5%和-12.2%/-0.3%。磨玻璃结节（GGN）的相应值分别为25.6%/81.0%、9.0%/28.0%、7.6%/20.6%和6.8%/21.2%。实性结节/GGN的平均RVD为1.3%/-15.2%。在LungRADS分类方面，DL CAD和标准CAD分别正确分类了88.5%和79.8%的所有实性结节。14.9%的结节在两个系统之间的分类不同。
结论
CAD系统的体积测量误差可能会影响患者管理，因此需要放射科医生进行监督和/或人工校正。
关键点
• 与标准CAD系统相比，基于DL的CAD系统在GGN体积测量方面更准确，而在实性结节方面准确性较低。
• 结节大小和衰减对两种系统的测量准确性都有影响；管电压对测量准确性没有影响。
• CAD系统的测量误差可能会对患者管理产生影响，这需要放射科医生进行监督。
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