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ABSTRACT: Background
To develop and validate a contrast-enhanced CT based classification tree model for classifying solid lung tumors in clinical patients into malignant or benign.Methods
Between January 2015 and October 2017, 827 pathologically confirmed solid lung tumors (487 malignant, 340 benign; median size, 27.0 mm, IQR 18.0-39.0 mm) from 827 patients from a dedicated Chinese cancer hospital were identified. Nodules were divided randomly into two groups, a training group (575 cases) and a testing group (252 cases). CT characteristics were collected by two radiologists, and analyzed using a classification and regression tree (CART) model. For validation, we used the decision analysis threshold to evaluate the classification performance of the CART model and radiologist's diagnosis (benign; malignant) in the testing group.Results
Three out of 19 characteristics [margin (smooth; slightly lobulated/lobulated/spiculated), and shape (round/oval; irregular), subjective enhancement (no/uniform enhancement; heterogeneous enhancement)] were automatically generated by the CART model for classifying solid lung tumors. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the CART model is 98.5%, 58.1%, 80.6%, 98.6%, 79.8%, and 90.4%, 54.7%, 82.4% 98.5%, 74.2% for the radiologist's diagnosis by using three-threshold decision analysis.Conclusions
Tumor margin and shape, and subjective tumor enhancement were the most important CT characteristics in the CART model for classifying solid lung tumors as malignant. The CART model had higher discriminatory power than radiologist's diagnosis. The CART model could help radiologists making recommendations regarding follow-up or surgery in clinical patients with a solid lung tumor.
SUBMITTER: Cui X
PROVIDER: S-EPMC8339765 | biostudies-literature | 2021 Jul
REPOSITORIES: biostudies-literature
Cui Xiaonan X Heuvelmans Marjolein A MA Sidorenkov Grigory G Zhao Yingru Y Fan Shuxuan S Groen Harry J M HJM Dorrius Monique D MD Oudkerk Matthijs M de Bock Geertruida H GH Vliegenthart Rozemarijn R Ye Zhaoxiang Z
Journal of thoracic disease 20210701 7
<h4>Background</h4>To develop and validate a contrast-enhanced CT based classification tree model for classifying solid lung tumors in clinical patients into malignant or benign.<h4>Methods</h4>Between January 2015 and October 2017, 827 pathologically confirmed solid lung tumors (487 malignant, 340 benign; median size, 27.0 mm, IQR 18.0-39.0 mm) from 827 patients from a dedicated Chinese cancer hospital were identified. Nodules were divided randomly into two groups, a training group (575 cases) ...[more]