An [18F]FDG-PET/CT deep learning method for fully automated detection of pathological mediastinal lymph nodes in lung cancer patients.

Purpose: The identification of pathological mediastinal lymph nodes is an important step in the staging of lung cancer, with the presence of metastases significantly affecting survival rates. Nodes are currently identified by a physician, but this process is time-consuming and prone to errors. In th...

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Publicado en:European Journal of Nuclear Medicine & Molecular Imaging Vol. 49; no. 3; pp. 881 - 889
Autores principales: Wallis, David, Soussan, Michaël, Lacroix, Maxime, Akl, Pia, Duboucher, Clément, Buvat, Irène
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Feb2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2022
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00259-021-05513-x
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        atl: An [18F]FDG-PET/CT deep learning method for fully automated detection of pathological mediastinal lymph nodes in lung cancer patients.
      aug:
        au:
          Wallis, David
          Soussan, Michaël
          Lacroix, Maxime
          Akl, Pia
          Duboucher, Clément
          Buvat, Irène
        affil: Laboratoire D'Imagerie Translationnelle en Oncologie, U1288 Inserm, Institut Curie, PSL, Université Paris Saclay, Paris, France
      sug:
        subj:
          Lung Neoplasms
          Lymphatic Diseases Diagnosis
          Radiographic Image Interpretation, Computer-Assisted
          Deep Learning
          Human
          Retrospective Design
          Fludeoxyglucose F 18
          Positron-Emission Tomography
          Tomography, X-Ray Computed
          Sensitivity and Specificity
          Confidence Intervals
      ab: Purpose: The identification of pathological mediastinal lymph nodes is an important step in the staging of lung cancer, with the presence of metastases significantly affecting survival rates. Nodes are currently identified by a physician, but this process is time-consuming and prone to errors. In this paper, we investigate the use of artificial intelligence–based methods to increase the accuracy and consistency of this process. Methods: Whole-body 18F-labelled fluoro-2-deoxyglucose ([18F]FDG) positron emission tomography/computed tomography ([18F]FDG-PET/CT) scans (Philips Gemini TF) from 134 patients were retrospectively analysed. The thorax was automatically located, and then slices were fed into a U-Net to identify candidate regions. These regions were split into overlapping 3D cubes, which were individually predicted as positive or negative using a 3D CNN. From these predictions, pathological mediastinal nodes could be identified. A second cohort of 71 patients was then acquired from a different, newer scanner (GE Discovery MI), and the performance of the model on this dataset was tested with and without transfer learning. Results: On the test set from the first scanner, our model achieved a sensitivity of 0.87 (95% confidence intervals [0.74, 0.94]) with 0.41 [0.22, 0.71] false positives/patient. This was comparable to the performance of an expert. Without transfer learning, on the test set from the second scanner, the corresponding results were 0.53 [0.35, 0.70] and 0.24 [0.10, 0.49], respectively. With transfer learning, these metrics were 0.88 [0.73, 0.97] and 0.69 [0.43, 1.04], respectively. Conclusion: Model performance was comparable to that of an expert on data from the same scanner. With transfer learning, the model can be applied to data from a different scanner. To our knowledge it is the first study of its kind to go directly from whole-body [18F]FDG-PET/CT scans to pathological mediastinal lymph node localisation.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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