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一种用于预测肺结节良恶性的人工智能辅助诊断系统及其对不同临床特征患者的实用价值。

An artificial intelligence-assisted diagnostic system for the prediction of benignity and malignancy of pulmonary nodules and its practical value for patients with different clinical characteristics.

作者信息

Zhang Lichuan, Shao Yue, Chen Guangmei, Tian Simiao, Zhang Qing, Wu Jianlin, Bai Chunxue, Yang Dawei

机构信息

Department of Respiratory Medicine, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.

Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China.

出版信息

Front Med (Lausanne). 2023 Dec 22;10:1286433. doi: 10.3389/fmed.2023.1286433. eCollection 2023.

Abstract

OBJECTIVES

This study aimed to explore the value of an artificial intelligence (AI)-assisted diagnostic system in the prediction of pulmonary nodules.

METHODS

The AI system was able to make predictions of benign or malignant nodules. 260 cases of solitary pulmonary nodules (SPNs) were divided into 173 malignant cases and 87 benign cases based on the surgical pathological diagnosis. A stratified data analysis was applied to compare the diagnostic effectiveness of the AI system to distinguish between the subgroups with different clinical characteristics.

RESULTS

The accuracy of AI system in judging benignity and malignancy of the nodules was 75.77% ( < 0.05). We created an ROC curve by calculating the true positive rate (TPR) and the false positive rate (FPR) at different threshold values, and the AUC was 0.755. Results of the stratified analysis were as follows. (1) By nodule position: the AUC was 0.677, 0.758, 0.744, 0.982, and 0.725, respectively, for the nodules in the left upper lobe, left lower lobe, right upper lobe, right middle lobe, and right lower lobe. (2) By nodule size: the AUC was 0.778, 0.771, and 0.686, respectively, for the nodules measuring 5-10, 10-20, and 20-30 mm in diameter. (3) The predictive accuracy was higher for the subsolid pulmonary nodules than for the solid ones (80.54 vs. 66.67%).

CONCLUSION

The AI system can be applied to assist in the prediction of benign and malignant pulmonary nodules. It can provide a valuable reference, especially for the diagnosis of subsolid nodules and small nodules measuring 5-10 mm in diameter.

摘要

目的

本研究旨在探讨人工智能(AI)辅助诊断系统在预测肺结节方面的价值。

方法

该AI系统能够对良性或恶性结节进行预测。根据手术病理诊断,将260例孤立性肺结节(SPN)分为173例恶性病例和87例良性病例。应用分层数据分析来比较AI系统区分具有不同临床特征亚组的诊断效能。

结果

AI系统判断结节良恶性的准确率为75.77%(<0.05)。通过计算不同阈值下的真阳性率(TPR)和假阳性率(FPR)创建了ROC曲线,曲线下面积(AUC)为0.755。分层分析结果如下:(1)按结节位置:左上叶、左下叶、右上叶、右中叶和右下叶结节的AUC分别为0.677、0.758、0.744、0.982和0.725。(2)按结节大小:直径为5 - 10、10 - 20和20 - 30 mm的结节的AUC分别为0.778、0.771和0.686。(3)亚实性肺结节的预测准确率高于实性肺结节(80.54%对66.67%)。

结论

AI系统可用于辅助预测肺结节的良恶性。它能提供有价值的参考,特别是对于亚实性结节和直径为5 - 10 mm的小结节的诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f63/10774219/c1c571d24a37/fmed-10-1286433-g001.jpg

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