Assessing probability of malignancy in solid solitary pulmonary nodules with a new Bayesian calculator: improving diagnostic accuracy by means of expanded and updated features.

Objectives: A crucial point in the work-up of a solitary pulmonary nodule (SPN) is to accurately characterise the lesion on the basis of imaging and clinical data available. We introduce a new Bayesian calculator as a tool to assess and grade SPN risk of malignancy.Methods: A set of 343 consecutive...

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Publicado en:European Radiology Vol. 25; no. 1; pp. 155 - 163
Autores principales: Soardi, G A, Perandini, Simone, Motton, M, Montemezzi, S
Formato: research Journal Article
Publicado: Springer Nature Jan2015
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2015
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      pub: Springer Nature
      place: New York, New York
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        atl: Assessing probability of malignancy in solid solitary pulmonary nodules with a new Bayesian calculator: improving diagnostic accuracy by means of expanded and updated features.
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          Soardi, G A
          Perandini, Simone
          Motton, M
          Montemezzi, S
        affil: Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, 37124, Verona, Italy.
      sug:
        subj:
          Lung Neoplasms Pathology
          Solitary Pulmonary Nodule Pathology
          Adult
          Aged
          Aged, 80 and Over
          Biopsy
          Early Detection of Cancer
          Epidemiological Research
          Female
          Human
          Male
          Middle Age
          Body Weights and Measures
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Objectives: A crucial point in the work-up of a solitary pulmonary nodule (SPN) is to accurately characterise the lesion on the basis of imaging and clinical data available. We introduce a new Bayesian calculator as a tool to assess and grade SPN risk of malignancy.Methods: A set of 343 consecutive biopsy or interval proven SPNs was used to develop a calculator to predict SPN probability of malignancy. The model was validated on the study population in a "round-robin" fashion and compared with results obtained from current models described in literature.Results: In our case series, receiver operating characteristic (ROC) analysis showed an area under the curve (AUC) of 0.893 for the proposed model and 0.795 for its best competitor, which was the Gurney calculator. Using observational thresholds of 5% and 10% our model returned fewer false-negative results, while showing constant superiority in avoiding false-positive results for each surgical threshold tested. The main downside of the proposed calculator was a slightly higher proportion of indeterminate SPNs.Conclusions: We believe the proposed model to be an important update of current Bayesian analysis of SPNs, and to allow for better discrimination between malignancies and benign entities on the basis of clinical and imaging data.Key Points: • Bayesian analysis can help characterise solitary pulmonary nodules • Volume doubling time (VDT) is a good predictor of malignancy • A VDT of between 25 and 400 days is highly suggestive of malignancy • Nodule size, enhancement, morphology and VDT are the best predictors of malignancy.
      pubtype: Academic Journal
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        research
        Journal Article
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    language: English
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