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Radiology:在超低剂量胸部CT中,深度学习可实现肺结节的“既要、又要、还要”

2022-03-11 shaosai MedSci原创

据统计,肺癌是现阶段全球范围内癌症相关死亡的主要原因,占总数的18.4%。大量的CT筛查可以将肺癌的10年死亡率降低24%。尽管对肺癌筛查的需求迅速增加,但辐射暴露的累积负荷限制了其进一步的广泛应用。

统计肺癌现阶段全球范围内癌症相关死亡的主要原因,占总数的18.4%。大量的CT筛查可以将肺癌的10年死亡率降低24%。尽管对肺癌筛查的需求迅速增加,但辐射暴露的累积负荷限制了其进一步的广泛应用。在保证诊断准确性的前提下,尽可能地减少辐射剂量至关重要。然而,传统的图像重建方法并不能减少低剂量采集的图像噪声。现阶段临床上引入了迭代重建,如ASIR-V和ADMIRE用来重建图像和减少噪声。在低剂量CT背景下,迭代重建可以显著减少图像噪声提高图像质量。

最近,临床上引入了基于卷积神经网络的深度学习图像重建(DLIR)技术以改善低剂量环境下的图像质量。近日,发表在Radiology杂志的一项研究比较DLIR和ASIR-V在超低剂量(ULD)CT中的图像质量和肺部结节显示情况在保证图像质量的同时进一步减少辐射剂量。

本研究对2020年4月至6月期间进行平扫ULD CT(在0.07或0.14 mSv下进行,类似于单张胸片)和对比增强胸部CT(CECT)扫描的患者被进行了评估。ULD CT图像用滤波背投(FBP)、ASIR-V和DLIR进行重建。对肺组织进行了三维分割以评估图像噪声。放射医师利用基于深度学习的结节评估系统检测和测量结节,并识别与恶性肿瘤相关的影像特征。用Bland-Altman分析和重复测量方差分析来评估ULD CT图像和CECT图像之间的差异。

共纳入203名参与者(平均年龄±标准差,61岁±12岁;129名男性),有1066个结节,其中100次扫描为0.07mSv,103次扫描为0.14mSv。CECT的平均肺组织噪声±标准差为46 HU±4,ULD CT扫描的FBP、ASIR-V水平40%、ASIR-V水平80%(ASIR-V-80%)、中等强度DLIR和高强度DLIR(DLIR-H)分别为59 HU±4、56 HU±4、53 HU±4、54 HU±4和51 HU±4(P < .001)。FBP重建、ASIR-V-80%和DLIR-H的结节检出率分别为62.5%(1066个结节中的666个)、73.3%(1066个结节中的781个)和75.8%(1066个结节中的808个)(P < .001)。Bland-Altman分析显示,在FBP重建、ASIR-V-80%和DLIR-H中,长径与CECT的百分比差异分别为9.3%(95%平均CI:8.0,10.6)、9.2%(95%平均CI:8.0,10.4)和6.2%(95%平均CI:5.0,7.4)(P < .001)。

 

 来自DLIR和ASIR-V的具有代表性胸部CT图像。72岁男性,体重指数为19.0kg/m2,5年前有右中叶肺癌手术的临床病史。这四张图像包括作为参考的CECT图像(使用ASIR-V 50%水平重建)和0.14mSv超低剂量CT下的滤波背投(FBP)、ASIR-V 80%水平(ASIR-V-80%)和高强度DLIR(DLIR-H)图像。红色勾勒的区域显示了肺实质的放大图像的细节。DLIR-H图像比ASIR-V-80%图像显示更清晰的肺实质和更多的细节,与CECT图像相似。

ASIR-V相比,深度学习图像重建(DLIR)技术可通过减少图像噪声和提高肺部结节检测率来改善图像质量。DLIR还提高了结节测量的准确性,并显示了更详细的与恶性肿瘤相关的结节影像学特征。随着这种特定的DLIR算法的引入,在体重不足和体重正常的参与者中使用低至0.14 mSv的等效胸部CT采集来检测和描述肺部结节是可行的,这对于促进大规模肺癌筛查的临床实施至关重要。

原文出处

Beibei Jiang,Nianyun Li,Xiaomeng Shi,et al.Deep Learning Reconstruction Shows Better Lung Nodule Detection for Ultra-Low-Dose Chest CT.DOI:10.1148/radiol.210551

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    2022-03-13 lq1768
  2. [GetPortalCommentsPageByObjectIdResponse(id=1401158, encodeId=c26614011581e, 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=78, 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=Sun Mar 13 00:14:40 CST 2022, time=2022-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480626, encodeId=fb15148062668, 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=76, 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=Sun Mar 13 00:14:40 CST 2022, time=2022-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201820, encodeId=100512018203f, content=分辨率,辨识度越来越强了, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3c2b1620925, createdName=泽9867, createdTime=Fri Mar 11 22:48:28 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201771, encodeId=81b51201e7197, content=好东西,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0be2111725, createdName=萌宝嘟嘟, createdTime=Fri Mar 11 20:04:15 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201687, encodeId=c2a5120168ee7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=821f2227826, createdName=DR.Fu SIR, createdTime=Fri Mar 11 14:11:23 CST 2022, time=2022-03-11, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1401158, encodeId=c26614011581e, 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=78, 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=Sun Mar 13 00:14:40 CST 2022, time=2022-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480626, encodeId=fb15148062668, 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=76, 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=Sun Mar 13 00:14:40 CST 2022, time=2022-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201820, encodeId=100512018203f, content=分辨率,辨识度越来越强了, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3c2b1620925, createdName=泽9867, createdTime=Fri Mar 11 22:48:28 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201771, encodeId=81b51201e7197, content=好东西,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0be2111725, createdName=萌宝嘟嘟, createdTime=Fri Mar 11 20:04:15 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201687, encodeId=c2a5120168ee7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=821f2227826, createdName=DR.Fu SIR, createdTime=Fri Mar 11 14:11:23 CST 2022, time=2022-03-11, status=1, ipAttribution=)]
    2022-03-11 泽9867

    分辨率,辨识度越来越强了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1401158, encodeId=c26614011581e, 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=78, 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=Sun Mar 13 00:14:40 CST 2022, time=2022-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480626, encodeId=fb15148062668, 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=76, 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=Sun Mar 13 00:14:40 CST 2022, time=2022-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201820, encodeId=100512018203f, content=分辨率,辨识度越来越强了, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3c2b1620925, createdName=泽9867, createdTime=Fri Mar 11 22:48:28 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201771, encodeId=81b51201e7197, content=好东西,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0be2111725, createdName=萌宝嘟嘟, createdTime=Fri Mar 11 20:04:15 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201687, encodeId=c2a5120168ee7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=821f2227826, createdName=DR.Fu SIR, createdTime=Fri Mar 11 14:11:23 CST 2022, time=2022-03-11, status=1, ipAttribution=)]
    2022-03-11 萌宝嘟嘟

    好东西,谢谢分享!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1401158, encodeId=c26614011581e, 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=78, 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=Sun Mar 13 00:14:40 CST 2022, time=2022-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480626, encodeId=fb15148062668, 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=76, 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=Sun Mar 13 00:14:40 CST 2022, time=2022-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201820, encodeId=100512018203f, content=分辨率,辨识度越来越强了, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3c2b1620925, createdName=泽9867, createdTime=Fri Mar 11 22:48:28 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201771, encodeId=81b51201e7197, content=好东西,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0be2111725, createdName=萌宝嘟嘟, createdTime=Fri Mar 11 20:04:15 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201687, encodeId=c2a5120168ee7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=821f2227826, createdName=DR.Fu SIR, createdTime=Fri Mar 11 14:11:23 CST 2022, time=2022-03-11, status=1, ipAttribution=)]
    2022-03-11 DR.Fu SIR

    学习了

    0

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