Artificial intelligence for detecting small FDG-positive lung nodules in digital PET/CT: impact of image reconstructions on diagnostic performance.

Objectives: To evaluate the diagnostic performance of a deep learning algorithm for automated detection of small 18F-FDG-avid pulmonary nodules in PET scans, and to assess whether novel block sequential regularized expectation maximization (BSREM) reconstruction affects detection accuracy as compare...

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Publicado en:European Radiology Vol. 30; no. 4; pp. 2031 - 2041
Autores principales: Schwyzer, Moritz, Martini, Katharina, Benz, Dominik C., Burger, Irene A., Ferraro, Daniela A., Kudura, Ken, Treyer, Valerie, von Schulthess, Gustav K., Kaufmann, Philipp A., Huellner, Martin W., Messerli, Michael
Formato: Journal Article
Publicado: Springer Nature Apr2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2020
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      pub: Springer Nature
      place: New York, New York
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        atl: Artificial intelligence for detecting small FDG-positive lung nodules in digital PET/CT: impact of image reconstructions on diagnostic performance.
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          Schwyzer, Moritz
          Martini, Katharina
          Benz, Dominik C.
          Burger, Irene A.
          Ferraro, Daniela A.
          Kudura, Ken
          Treyer, Valerie
          von Schulthess, Gustav K.
          Kaufmann, Philipp A.
          Huellner, Martin W.
          Messerli, Michael
        affil: Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
      sug:
        subj:
          Lung Neoplasms
          Solitary Pulmonary Nodule
          Aged, 80 and Over
          Male
          Radiopharmaceuticals
          Retrospective Design
          Lung Neoplasms Pathology
          Image Processing, Computer Assisted Methods
          Artificial Intelligence
          Algorithms
          Female
          Aged
          Middle Age
          Sensitivity and Specificity
          Adult
          Solitary Pulmonary Nodule Pathology
          Fludeoxyglucose F 18
          Impact of Events Scale
          Scales
          Aged, 80 & over
          Aged: 65+ years
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Male
          Female
      ab: Objectives: To evaluate the diagnostic performance of a deep learning algorithm for automated detection of small 18F-FDG-avid pulmonary nodules in PET scans, and to assess whether novel block sequential regularized expectation maximization (BSREM) reconstruction affects detection accuracy as compared to ordered subset expectation maximization (OSEM) reconstruction.Methods: Fifty-seven patients with 92 18F-FDG-avid pulmonary nodules (all ≤ 2 cm) undergoing PET/CT for oncological (re-)staging were retrospectively included and a total of 8824 PET images of the lungs were extracted using OSEM and BSREM reconstruction. Per-slice and per-nodule sensitivity of a deep learning algorithm was assessed, with an expert readout by a radiologist/nuclear medicine physician serving as standard of reference. Receiver-operator characteristic (ROC) curve of OSEM and BSREM were assessed and the areas under the ROC curve (AUC) were compared. A maximum standardized uptake value (SUVmax)-based sensitivity analysis and a size-based sensitivity analysis with subgroups defined by nodule size was performed.Results: The AUC of the deep learning algorithm for nodule detection using OSEM reconstruction was 0.796 (CI 95%; 0.772-0.869), and 0.848 (CI 95%; 0.828-0.869) using BSREM reconstruction. The AUC was significantly higher for BSREM compared to OSEM (p = 0.001). On a per-slice analysis, sensitivity and specificity were 66.7% and 79.0% for OSEM, and 69.2% and 84.5% for BSREM. On a per-nodule analysis, the overall sensitivity of OSEM was 81.5% compared to 87.0% for BSREM.Conclusions: Our results suggest that machine learning algorithms may aid detection of small 18F-FDG-avid pulmonary nodules in clinical PET/CT. AI performed significantly better on images with BSREM than OSEM.Key Points: • The diagnostic value of deep learning for detecting small lung nodules (≤ 2 cm) in PET images using BSREM and OSEM reconstruction was assessed. • BSREM yields higher SUVmaxof small pulmonary nodules as compared to OSEM reconstruction. • The use of BSREM translates into a higher detectability of small pulmonary nodules in PET images as assessed with artificial intelligence.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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