Sun Qian, Yu Lei, Song Zhongquan, Wang Can, Li Wei, Chen Wang, Xu Juan, Han Shuhua
Department of Pulmonary and Critical Care Medicine, Medical School, Zhongda Hospital, Southeast University, No. 87 Dingjia Bridge, Nanjing, 210009, Jiangsu, China.
Department of Respiratory Medicine, The First People's Hospital of Yancheng, The Yancheng Clinical College of Xuzhou Medical University, No. 66 Renmin South Road, Yancheng, 224006, China.
Sci Rep. 2025 Aug 11;15(1):29285. doi: 10.1038/s41598-025-13447-9.
Microinvasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC) require distinct treatment strategies and are associated with different prognoses, underscoring the importance of accurate differentiation. This study aims to develop a predictive model that combines radiomics and deep learning to effectively distinguish between MIA and IAC. In this retrospective study, 252 pathologically confirmed cases of ground-glass nodules (GGNs) were included, with 177 allocated to the training set and 75 to the testing set. Radiomics, 2D deep learning, and 3D deep learning models were constructed based on CT images. In addition, two fusion strategies were employed to integrate these modalities: early fusion, which concatenates features from all modalities prior to classification, and late fusion, which ensembles the output probabilities of the individual models. The predictive performance of all five models was evaluated using the area under the receiver operating characteristic curve (AUC), and DeLong's test was performed to compare differences in AUC between models. The radiomics model achieved an AUC of 0.794 (95% CI: 0.684-0.898), while the 2D and 3D deep learning models achieved AUCs of 0.754 (95% CI: 0.594-0.882) and 0.847 (95% CI: 0.724-0.945), respectively, in the testing set. Among the fusion models, the late fusion strategy demonstrated the highest predictive performance, with an AUC of 0.898 (95% CI: 0.784-0.962), outperforming the early fusion model, which achieved an AUC of 0.857 (95% CI: 0.731-0.936). Although the differences were not statistically significant, the late fusion model yielded the highest numerical values for diagnostic accuracy, sensitivity, and specificity across all models. The fusion of radiomics and deep learning features shows potential in improving the differentiation of MIA and IAC in GGNs. The late fusion strategy demonstrated promising results, warranting further validation in larger, multicenter studies.
微浸润腺癌(MIA)和浸润性腺癌(IAC)需要不同的治疗策略,且预后不同,这凸显了准确鉴别诊断的重要性。本研究旨在开发一种结合放射组学和深度学习的预测模型,以有效区分MIA和IAC。在这项回顾性研究中,纳入了252例经病理证实的磨玻璃结节(GGN)病例,其中177例分配到训练集,75例分配到测试集。基于CT图像构建了放射组学、二维深度学习和三维深度学习模型。此外,采用了两种融合策略来整合这些模型:早期融合,即在分类前将所有模型的特征串联起来;晚期融合,即将各个模型的输出概率进行整合。使用受试者操作特征曲线下面积(AUC)评估所有五个模型的预测性能,并进行德龙检验以比较各模型之间AUC的差异。在测试集中,放射组学模型的AUC为0.794(95%CI:0.684 - 0.898),二维和三维深度学习模型的AUC分别为0.754(95%CI:0.594 - 0.882)和0.847(95%CI:0.724 - 0.945)。在融合模型中,晚期融合策略表现出最高的预测性能,AUC为0.898(95%CI:0.784 - 0.962),优于早期融合模型,早期融合模型的AUC为0.857(95%CI:0.731 - 0.936)。尽管差异无统计学意义,但晚期融合模型在所有模型中的诊断准确性、敏感性和特异性的数值最高。放射组学和深度学习特征的融合在改善GGN中MIA和IAC的鉴别诊断方面显示出潜力。晚期融合策略显示出有前景的结果,值得在更大规模的多中心研究中进一步验证。
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