Validation of the BRODERS classifier (Benign versus aggressive nODule Evaluation using Radiomic Stratification), a novel high-resolution computed tomography-based radiomic classifier for indeterminate pulmonary nodules

2020 ◽  
pp. 2002485
Author(s):  
Fabien Maldonado ◽  
Cyril Varghese ◽  
Srinivasan Rajagopalan ◽  
Fenghai Duan ◽  
Aneri Balar ◽  
...  
Keyword(s):  
Computed Tomography ◽  
External Validation ◽  
Lung Nodule ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Pretest Probability ◽  
Imaging Features ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Predictive Values

IntroductionImplementation of low-dose chest computed tomography (CT) lung cancer screening and the ever-increasing use of cross-sectional imaging are resulting in the identification of many screen- and incidentally detected indeterminate pulmonary nodules. While the management of nodules with low or high pretest probability of malignancy is relatively straightforward, those with intermediate pretest probability commonly require advanced imaging or biopsy. Non-invasive risk stratification tools are highly desirable.MethodsWe previously developed the BRODERS classifier (Benign versus aggRessive nODule Evaluation using Radiomic Stratification), a conventional predictive radiomic model based on 8 imaging features capturing nodule location, shape, size, texture and surface characteristics. Herein we report its external validation using a dataset of incidentally identified lung nodules (Vanderbilt University Lung Nodule Registry) in comparison to the Brock model. Area under the curve (AUC), as well as sensitivity, specificity, negative and positive predictive values were calculated.ResultsFor the entire Vanderbilt validation set (n=170, 54% malignant), the AUC was 0.87 (95% CI=0.81–0.92) for the Brock model and 0.90 (95% CI=0.85–0.94) for the BRODERS model. Using the optimal cutoff determined by Youden's Index, the sensitivity was 92.3%, the specificity was 62.0%, the positive (PPV) and negative predictive values (NPV) were 73.7% and 87.5%, respectively. For nodules with intermediate pre-test probability of malignancy, Brock score of 5–65% (n=97), the Sensitivity and Specificity were 94% and 46%, the PPV was 78.4% and the NPV was 79.2%, respectively.ConclusionsThe BRODERS radiomic predictive model performs well on an independent dataset and may facilitate the management of indeterminate pulmonary nodules.

scholarly journals Imaging diagnosis of classical and new pneumoconiosis: predominant reticular HRCT pattern

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Akira Masanori
Keyword(s):  
Computed Tomography ◽  
Interstitial Lung Disease ◽  
Imaging Features ◽  
Imaging Findings ◽  
Imaging Diagnosis ◽  
High Resolution Computed Tomography ◽  
Pleural Fibrosis ◽  
Pathologic Findings ◽  
Characteristic Imaging ◽  
The Individual

AbstractOur understanding of the manifestations of pneumoconioses is evolving in recent years. Associations between novel exposures and diffuse interstitial lung disease have been newly recognized. In advanced asbestosis, two types of fibrosis are seen, probably related to dose of exposure, existence of pleural fibrosis, and the host factor status of the individual. In pneumoconiosis of predominant reticular type, nodular opacities are often seen in the early phase. The nodular pattern is centrilobular, although some in metal lung show perilymphatic distribution, mimicking sarcoidosis. High-resolution computed tomography enables a more comprehensive correlation between the pathologic findings and clinically relevant imaging findings. The clinician must understand the spectrum of characteristic imaging features related to both known dust exposures and to historically recent new dust exposures.

Diagnostic Accuracy of HRCT Chest in Detection of Covid-19 Infection Taking PCR as Gold Standard

2021 ◽  
Vol 15 (6) ◽  
pp. 1679-1681
Author(s):  
Afaque Ali ◽  
Majid Shaikh ◽  
Ahsanullah . ◽  
Adeel Ahmed ◽  
Abid Ali Sahito ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Cross Sectional Study ◽  
Radiology Department ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Head Of Department

Objective: To determine the diagnostic accuracy of High-resolution computed tomography (HRCT) chest in detection of covid-19 infection taking PCR as gold standard. Study Design: Cross-sectional study Setting: Radiology department of Tabba Hospital, Karachi. Duration: From March 2019 to September 2020 Material and Methods: All the clinically suspected patients of covid-19, of any age, both genders and those referred to radiology for High-resolution computed tomography (HRCT) chest to detect the covid-19 infection were included. After two days, patients’ PCR reports were collected from the ward, after taking informed consent and permission from head of department. The diagnostic accuracy of HRCT was established with respect to sensitivity, PPV, NPV, and specificity by taking PCR as gold standard. All the information was collected via study proforma. Results: Total 70 patients suspected for COVID-19 were studied, and the patients’ mean age was 58.23±9.52 years. Males were in majority 54(77.1%). As per HRCT findings, COVID-19 infection was positive in 46 patients, however, 48 patients were detected positive for COVID-19 infection as per PCR findings. In the detection of COVID-19 infection, HRCT chest showed sensitivity of 91%, specificity of 90%, PPV of 83%, NPV of 84% and diagnostic accuracy of 94%; by taking PCR as gold standard. Conclusion: High-resolution computed tomography (HRCT) is a reliable diagnostic approach in promptly detecting the COVID-19; with 91% sensitivity, 90% specificity, 83% positive predictive value, 84% negative predictive value and 94% diagnostic accuracy. Keywords: Accuracy, HRCT, COVID-19

scholarly journals The Roth score as a triage tool for detecting hypoxaemia in general practice: a diagnostic validation study in patients with possible COVID-19

2021 ◽  
Vol 22 ◽  
Author(s):  
Charlotte E.M. ten Broeke ◽  
Jelle C.L. Himmelreich ◽  
Jochen W.L. Cals ◽  
Wim A.M. Lucassen ◽  
Ralf E. Harskamp
Keyword(s):  
General Practice ◽  
Validation Study ◽  
Virus Disease ◽  
External Validation ◽  
Added Value ◽  
Cross Sectional ◽  
Predictive Values ◽  
Single Breath ◽  
C Statistic ◽  
Counting Time

Abstract Aim: To validate the Roth score as a triage tool for detecting hypoxaemia. Backgrounds: The virtual assessment of patients has become increasingly important during the corona virus disease (COVID-19) pandemic, but has limitations as to the evaluation of deteriorating respiratory function. This study presents data on the validity of the Roth score as a triage tool for detecting hypoxaemia remotely in potential COVID-19 patients in general practice. Methods: This cross-sectional validation study was conducted in Dutch general practice. Patients aged ≥18 with suspected or confirmed COVID-19 were asked to rapidly count from 1 to 30 in a single breath. The Roth score involves the highest number counted during exhalation (counting number) and the time taken to reach the maximal count (counting time). Outcome measures were (1) the correlation between both Roth score measurements and simultaneous pulse oximetry (SpO2) on room air and (2) discrimination (c-statistic), sensitivity, specificity and predictive values of the Roth score for detecting hypoxaemia (SpO2 < 95%). Findings: A total of 33 physicians enrolled 105 patients (52.4% female, mean age of 52.6 ± 20.4 years). A positive correlation was found between counting number and SpO2 (rs = 0.44, P < 0.001), whereas only a weak correlation was found between counting time and SpO2 (rs = 0.15, P = 0.14). Discrimination for hypoxaemia was higher for counting number [c-statistic 0.91 (95% CI: 0.85–0.96)] than for counting time [c-statistic 0.77 (95% CI: 0.62–0.93)]. Optimal diagnostic performance was found at a counting number of 20, with a sensitivity of 93.3% (95% CI: 68.1–99.8) and a specificity of 77.8% (95% CI: 67.8–85.9). A counting time of 7 s showed the best sensitivity of 85.7% (95% CI: 57.2–98.2) and specificity of 81.1% (95% CI: 71.5–88.6). Conclusions: A Roth score, with an optimal counting number cut-off value of 20, maybe of added value for signalling hypoxaemia in general practice. Further external validation is warranted before recommending integration in telephone triage.

scholarly journals Prediction of Extrathyroidal Extension Using Ultrasonography and Computed Tomography

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Doh Young Lee ◽  
Tack-Kyun Kwon ◽  
Myung-Whun Sung ◽  
Kwang Hyun Kim ◽  
J. Hun Hah
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Extrathyroidal Extension ◽  
Ct Scans ◽  
Imaging Features ◽  
Predictive Values ◽  
Preoperative Prediction ◽  
Ct Findings ◽  
Sensitivity Specificity ◽  
Thyroid Capsule

Objectives. The aim of the present study was to evaluate the value of high-resolution ultrasound (US) and computed tomography (CT) scan for preoperative prediction of the extrathyroidal extension (ETE).Methods. We analyzed the medical records of 377 patients with papillary thyroid carcinoma (PTC) with preoperative US and CT scan to calculate the sensitivity, specificity, and positive and negative predictive values of characteristics imaging features (such as contact and disruption of thyroid capsule) for the presence of ETE in postoperative pathologic examination. We also evaluated the diagnostic power for several combinations of US and CT findings.Results. ETE was present in 174 (46.2%) based on pathologic reports. The frequency of ETE was greater in the patients with greater degrees of tumor contact and disruption of capsule, as revealed by both US and CT scans (positive predictive value of 72.2% and 81.8%, resp.). Considering positive predictive values and AUC of US and CT categories, separately or combined, a combination of US and CT findings was most accurate for predicting ETE (83.0%, 0.744).Conclusions. This study suggests that ETE can be predicted most accurately by a combination of categories based on the findings of US and CT scans.

scholarly journals Dual-Energy Computed Tomography Lung in patients of Pulmonary Tuberculosis

2020 ◽  
Vol 10 ◽  
pp. 39
Author(s):  
Ahmad Umar Khan ◽  
Sachin Khanduri ◽  
Zikra Tarin ◽  
Syed Zain Abbas ◽  
Mushahid Husain ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Tuberculosis ◽  
Imaging Techniques ◽  
Ground Glass Opacity ◽  
Signs And Symptoms ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Pulmonary Tb

Objectives: The objective of this study was to characterize findings of high-resolution computed tomography (HRCT) and dual-energy CT (DECT) (80 keV, 140 keV, and mixed) in pulmonary tuberculosis (TB) patients and to compare and correlate HRCT and DECT findings. Material and Methods: This cross-sectional study was conducted on 67 patients of 18–65 years of age who were suspected cases of pulmonary TB with signs and symptoms of cough, fever, hemoptysis, sputum, night sweats, and weight loss with positive sputum AFB examinations/bronchoalveolar lavage. All the patients subjected to HRCT scan and followed with DECT scan. Comparison of various imaging techniques (DECT 80 keV, DECT 140 keV, and DECT mixed) with HRCT was done for detecting lung findings and data so obtained were subjected to statistical analysis. Results: On comparing the various imaging techniques with HRCT for detecting consolidation, tree in bud pattern, cavitary lesions, ground-glass opacity, bronchiectasis, atelectasis, nodules, granuloma, peribronchial thickening, and fibrosis, the maximum agreement of HRCT was found with DECT 80 keV and minimum agreement was found with DECT 140 keV. Conclusion: The study concluded that DECT 80 keV monochromatic reconstructions among 80 keV, mixed, and 140 keV monochromatic reconstructions in lung parenchyma window settings are a faster and better analytical tool for the assessment of findings of pulmonary TB when compared with HRCT.

scholarly journals Volumetric lung cancer screening reduces unnecessary low-dose computed tomography scans: results from a single-centre prospective trial on 4,119 subjects

2021 ◽  
Author(s):  
Gianluca Milanese ◽  
Federica Sabia ◽  
Roberta Eufrasia Ledda ◽  
Stefano Sestini ◽  
Alfonso Vittorio Marchiano' ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Cancer Screening ◽  
Low Dose ◽  
Prospective Trial ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Single Centre ◽  
Kappa Test ◽  
Low Dose Computed Tomography

Purpose. To compare low-dose computed tomography (LDCT) outcome and volume-doubling time (VDT) derived from measured volume (MV) and estimated volume (EV) of pulmonary nodules (PN) detected in a single-centre lung cancer screening trial. Materials and Methods. MV, EV and VDT were obtained for prevalent pulmonary nodules detected at the baseline round of the bioMILD trial. LDCT outcome (based on bioMILD thresholds) and VDT categories were simulated on a PN- and a screenees-based analysis. Weighted Cohen's kappa test was used to assess the agreement between diagnostic categories as per MV and EV. Results. 1,583 screenees displayed 2,715 pulmonary nodules. On a PN-based analysis 40.1% PNs would have been included in different LDCT categories if measured by MV or EV. Agreement between MV and EV was moderate (κ = 0.49) and fair (κ = 0.37) for LDCT outcome and VDT categories, respectively. On a screenees-based analysis, 46% pulmonary nodules would have been included in different LDCT categories if measured by MV or EV. Agreement between MV and EV was moderate (κ = 0.52) and fair (κ = 0.34) for LDCT outcome and VDT categories, respectively. Conclusions. Within a simulated lung cancer screening based on recommendation by estimated volumetry, the number of LDCT performed for the evaluation of pulmonary nodules would be higher as compared to the prospective volumetric management.

scholarly journals Imaging features of IRIS caused by AIDS and complicated by tuberculosis

2017 ◽  
Vol 6 (1) ◽  
pp. 20-24
Author(s):  
Wei Li ◽  
Wei Liu ◽  
Guiming Zhou
Keyword(s):  
Computed Tomography ◽  
Immune Reconstitution ◽  
Clinical Symptoms ◽  
Imaging Features ◽  
Common Complication ◽  
High Resolution Computed Tomography ◽  
Imaging Research ◽  
Relationship Of ◽  
Inflammatory Syndrome ◽  
The Relationship

Abstract Immune reconstitution inflammatory syndrome (IRIS), a common complication of AIDS, is further complicated by tuberculosis. Its clinical symptoms lack specificity but can be evaluated using diagnostic imaging. High-resolution computed tomography (HRCT) is useful in evaluating the morphology and internal microstructure of lesions associated with the syndrome, as well as the relationship of the internal microstructure with the surrounding tissues. This paper summarizes the present state and progress of imaging research on IRIS caused by AIDS and complicated by tuberculosis.

scholarly journals High resolution computed tomography and chest radiography findings among interstitial lung disease patients

2019 ◽  
Vol 9 (4) ◽  
pp. 24-27
Author(s):  
Anusmriti Pal ◽  
Manoj Kumar Yadav ◽  
Chiranjibi Pant ◽  
Bishow Kumar Shrestha
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Imaging Modality ◽  
Lung Parenchyma ◽  
Median Number ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Diffuse Parenchymal Lung Diseases

Background: Interstitial lung disease (ILD) is a heterogeneous group of diffuse parenchymal lung diseases, characterized by restrictive physiology, impaired gas exchange, pulmonary inflammation and fibrosis. Chest radiograph (CXR) may appear normal during initial course of the disease and may show few abnormalities. High resolution computed tomography (HRCT) chest is a most ac­curate non-invasive, high spatial resolution descriptive imaging modality for evaluation of lung parenchyma. It assesses presence, location, type and characterization of ILD in appropriate clinical setting. Our aim was to study radiological patterns and its distribution in CXR and HRCT chest of ILD patients. Methods: This was an observational, single centered, cross-sectional study conducted at author’s place over the period of 6 months starting from January 2018 using convenient sampling method. Data analysis was done using students t-test for comparison of means and chi-square test for proportions. Results: A total of 30 suspected or diagnosed patients of ILD were enrolled in our study and pat­terns found on CXR were correlated with that on HRCT chest. The number of findings in HRCT chest for a patient was significantly higher than CXR (Median number: 4 verses 2, P<0.001), commonest reticular opacity 50% in CXR and 56.6% HRCT. One subject had normal CXR. Conclusion: HRCT was superior to CXR in detection of all basic patterns and their distribution as­sociated with ILD as higher numbers of findings were detected by HRCT chest as compared to CXR. HRCT chest could characterize the abnormality and specify its location much more accurately.

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