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European Radiology:对肺结节的筛查,低剂量胸部CT究竟该如何选择?

2022-03-11 shaosai MedSci原创

尽管据调查,肺癌近几年的发病率有所下降,但仍占全世界癌症死亡人数的近四分之一。关于肺癌筛查的主要关注点之一是重复的CT检查所带来的累积辐射剂量。因此,需要进一步优化的CT筛查方案引入临床。

尽管据调查肺癌近几年的发病率有所下降,但仍占全世界癌症死亡人数的近四分之一。关于肺癌筛查的主要关注点之一是重复的CT检查所带来的累积辐射剂量。因此,需要进一步优化的CT筛查方案引入临床

计算机辅助检测(CAD)系统可以大幅提高结节检测的准确性。然而,由于系统的过度拟合、有限的普适性和大量的假阳性率等一系列的因素,导致这些系统的无法在临床广泛实施。迄今为止,有多项研究描述了剂量降低对传统CAD系统的影响,但关于对基于深度学习DL的CAD系统只有有限的数据研究

近日,发表在European Radiology杂志的一项研究建立一个可保持实性和磨玻璃密度结节的高检测率的最低辐射剂量的电压/电流组合,为基于DL的CAD系统创建一个优化的肺癌筛查方案同时评估率管电压、管电流、结节大小、位置和组成对系统性能的影响

本演技为68个胸腔模型配备了329个结节(150个磨玻璃,179个固体),有四种尺寸(5毫米、8毫米、10毫米、12毫米),用九种管电压/电流组合进行扫描。检查结果由一个市售的基于DL的CAD系统进行分析。结果通过比例的比较进行了比较。进行Logistic回归以评估管电压、管电流、结节大小、结节密度和结节位置的影响。 

有效剂量(E)最低且检测率无障碍的组合是80 kV/50 mAs(敏感性:97.9%,平均假阳性率(FPR):1.9,平均CTDIvol: 1.2 ± 0.4 mGy,平均E:0.66 mSv)。Logistic回归显示,管电压和电流对检测率的影响最大,而结节大小和密度没有明显影响。 

 真阳性发现(右上叶10毫米的磨玻璃结节)。

研究结果显示,减少剂量对基于DL的CAD系统的检测率有显著影响。管电压和管电流对软件的影响很大结节的密度和大小对软件的性能没有明显影响。本研究同时发现80 kV/50 mAs是保障结节检测不受影响的最低有效剂量组合。

原文出处

Alan A Peters,Adrian T Huber,Verena C Obmann,et al.Diagnostic validation of a deep learning nodule detection algorithm in low-dose chest CT: determination of optimized dose thresholds in a virtual screening scenario.DOI:10.1007/s00330-021-08511-7

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    2022-10-01 feather89
  2. [GetPortalCommentsPageByObjectIdResponse(id=1729420, encodeId=22631e29420ec, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Sat Oct 01 16:39:00 CST 2022, time=2022-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201773, encodeId=cd2c1201e73cf, content=好东西,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0be2111725, createdName=萌宝嘟嘟, createdTime=Fri Mar 11 20:04:25 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401156, encodeId=55fa140115604, content=<a href='/topic/show?id=e2de8422322' target=_blank style='color:#2F92EE;'>#胸部CT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84223, encryptionId=e2de8422322, topicName=胸部CT)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/o7RpnhFvZBIzqjGrBgqI0uzRLOMECqe0mUpMfFjUzOgITVyDyibNibupQsIC9cX2wJO3c8HCDxjD21MIQxtbI9Lg/132, createdBy=f64d2300444, createdName=lq1768, createdTime=Fri Mar 11 00:39:00 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480625, encodeId=321a1480625ea, content=<a href='/topic/show?id=647d2615939' target=_blank style='color:#2F92EE;'>#低剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26159, encryptionId=647d2615939, topicName=低剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97b17641126, createdName=ms1292405679162969, createdTime=Fri Mar 11 00:39:00 CST 2022, time=2022-03-11, status=1, ipAttribution=)]
    2022-03-11 萌宝嘟嘟

    好东西,谢谢分享!

    0

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    2022-03-11 lq1768
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