Classification Of Pulmonary Nodules Research Articles

An anthropomorphic diagnosis system of pulmonary nodules using weak annotation-based deep learning

The accurate categorization of lung nodules in CT scans is an essential aspect in the prompt detection and diagnosis of lung cancer. The categorization of grade and texture for nodules is particularly significant since it can aid radiologists and clinicians to make better-informed decisions concerning the management of nodules. However, currently existing nodule classification techniques have a singular function of nodule classification and rely on an extensive amount of high-quality annotation data, which does not meet the requirements of clinical practice. To address this issue, we develop an anthropomorphic diagnosis system of pulmonary nodules (PN) based on deep learning (DL) that is trained by weak annotation data and has comparable performance to full-annotation based diagnosis systems. The proposed system uses DL models to classify PNs (benign vs. malignant) with weak annotations, which eliminates the need for time-consuming and labor-intensive manual annotations of PNs. Moreover, the PN classification networks, augmented with handcrafted shape features acquired through the ball-scale transform technique, demonstrate capability to differentiate PNs with diverse labels, including pure ground-glass opacities, part-solid nodules, and solid nodules. Through 5-fold cross-validation on two datasets, the system achieved the following results: (1) an Area Under Curve (AUC) of 0.938 for PN localization and an AUC of 0.912 for PN differential diagnosis on the LIDC-IDRI dataset of 814 testing cases, (2) an AUC of 0.943 for PN localization and an AUC of 0.815 for PN differential diagnosis on the in-house dataset of 822 testing cases. In summary, our system demonstrates efficient localization and differential diagnosis of PNs in a resource limited environment, and thus could be translated into clinical use in the future.

Deep learning-based CT image for pulmonary nodule classification with intrathoracic fat: A multicenter study

Correctly distinguishing between benign and malignant pulmonary nodules can avoid unnecessary invasive procedures. However, existing models exhibit a deficiency in the study of fat regions. We aim to create a multimodal deep learning nomogram (DLN) using pulmonary nodule and intrathoracic fat (ITF) features to distinguish between benign and malignant nodules and further demonstrate that intrathoracic fat can enhance the performance of lung cancer prediction models. A segmentation methodology was devised for precisely delineating intranodular and perinodular region (IPN). The Swin Transformer was used for feature extraction. The least absolute shrinkage and selection operator (LASSO) regression was employed for feature selection. The nomogram integrating IPN and ITF signatures revealed better diagnostic accuracy than IPN signature alone (net reclassification improvement = 0.134, P<0.05, and integrated discrimination improvement = 0.078, P<0.05). In the internal test cohort, DLN obtained an area under the curve (AUC) of 0.913 (95 % CI: 0.870, 0.952). In the external test cohort, the AUC was 0.906 (95 % CI: 0.867, 0.938). There was no significant difference between the calibrated curve and perfectly calibrated curve in all cohorts (P>0.05). Decision curve analysis showed that the DLN was clinically useful. The DLN demonstrated substantial diagnostic value for distinguishing between benign and malignant pulmonary nodules. The incorporation of the ITF signature has enhanced the performance of DLN.

Tumour-pleura relationship on computed tomography (CT) provides effective risk stratification for peripheral pulmonary nodules with Lung Imaging Reporting and Data System (Lung-RADS) score of 4X.

Pulmonary nodules with Lung Imaging Reporting and Data System (Lung-RADS) 4X are of greater clinical significance, and accurate differentiation of pathological types and visceral pleural invasion (VPI) of Lung-RADS 4X peripheral pulmonary nodules before treatment can aid in stratification. This study set out to investigate whether the tumour-pleura relationship on computed tomography (CT) can provide effective risk stratification for peripheral pulmonary nodules with Lung-RADS 4X. This was a single institution, retrospective study of 482 consecutive patients with Lung-RADS score 4X, who were pathologically diagnosed with tuberculous granuloma and adenocarcinoma from January 2019 to December 2023. We assessed clinical factors (baseline characteristics and tumour markers) and CT findings. Univariate and multivariate logistic regression analyses were used to determine the classification of pulmonary nodules and predictors of VPI. Multivariate analysis revealed that gender [odds ratio (OR) =0.392; P<0.001], carcinoembryonic antigen (CEA) level (OR =8.331; P<0.001), type of nodules (OR =13.551 and 7.478; P<0.001 and P=0.016) and maximum base width of soft tissue component on the pleura side (OR =0.857; P=0.005) were significant independent factors for distinguishing tuberculous granuloma from adenocarcinoma. And the type of linear connection between lesion and pleura (OR =3.936; P<0.001), and the maximum base width of soft tissue components on the pleura side (OR =1.359; P=0.001) were correlated independently with VPI. The area under the curve (AUC) for predicting pulmonary nodules classification was 82.60% [95% confidence interval (CI): 78.85-86.35%), and the AUC for predicting VPI was 76.10% (95% CI: 69.83-82.38%). The tumour-pleura relationship will be helpful in further risk stratification for peripheral pulmonary nodules with a score of Lung-RADS 4X.

A Multi-Task Model for Pulmonary Nodule Segmentation and Classification.

In the computer-aided diagnosis of lung cancer, the automatic segmentation of pulmonary nodules and the classification of benign and malignant tumors are two fundamental tasks. However, deep learning models often overlook the potential benefits of task correlations in improving their respective performances, as they are typically designed for a single task only. Therefore, we propose a multi-task network (MT-Net) that integrates shared backbone architecture and a prediction distillation structure for the simultaneous segmentation and classification of pulmonary nodules. The model comprises a coarse segmentation subnetwork (Coarse Seg-net), a cooperative classification subnetwork (Class-net), and a cooperative segmentation subnetwork (Fine Seg-net). Coarse Seg-net and Fine Seg-net share identical structure, where Coarse Seg-net provides prior location information for the subsequent Fine Seg-net and Class-net, thereby boosting pulmonary nodule segmentation and classification performance. We quantitatively and qualitatively analyzed the performance of the model by using the public dataset LIDC-IDRI. Our results show that the model achieves a Dice similarity coefficient (DI) index of 83.2% for pulmonary nodule segmentation, as well as an accuracy (ACC) of 91.9% for benign and malignant pulmonary nodule classification, which is competitive with other state-of-the-art methods. The experimental results demonstrate that the performance of pulmonary nodule segmentation and classification can be improved by a unified model that leverages the potential correlation between tasks.

GC-WIR : 3D global coordinate attention wide inverted ResNet network for pulmonary nodules classification

PurposeCurrently, deep learning methods for the classification of benign and malignant lung nodules encounter challenges encompassing intricate and unstable algorithmic models, limited data adaptability, and an abundance of model parameters.To tackle these concerns, this investigation introduces a novel approach: the 3D Global Coordinated Attention Wide Inverted ResNet Network (GC-WIR). This network aims to achieve precise classification of benign and malignant pulmonary nodules, leveraging its merits of heightened efficiency, parsimonious parameterization, and robust stability.MethodsWithin this framework, a 3D Global Coordinate Attention Mechanism (3D GCA) is designed to compute the features of the input images by converting 3D channel information and multi-dimensional positional cues. By encompassing both global channel details and spatial positional cues, this approach maintains a judicious balance between flexibility and computational efficiency. Furthermore, the GC-WIR architecture incorporates a 3D Wide Inverted Residual Network (3D WIRN), which augments feature computation by expanding input channels. This augmentation mitigates information loss during feature extraction, expedites model convergence, and concurrently enhances performance. The utilization of the inverted residual structure imbues the model with heightened stability.ResultsEmpirical validation of the GC-WIR method is performed on the LUNA 16 dataset, yielding predictions that surpass those generated by previous models. This novel approach achieves an impressive accuracy rate of 94.32%, coupled with a specificity of 93.69%. Notably, the model’s parameter count remains modest at 5.76M, affording optimal classification accuracy.ConclusionFurthermore, experimental results unequivocally demonstrate that, even under stringent computational constraints, GC-WIR outperforms alternative deep learning methodologies, establishing a new benchmark in performance.

Pulmonary Nodule Detection, Segmentation and Classification Using Deep Learning: A Comprehensive Literature Review

Lung cancer is a leading cause of cancer-related deaths worldwide, emphasizing the significance of early detection. Computer-aided diagnostic systems have emerged as valuable tools for aiding radiologists in the analysis of medical images, particularly in the context of lung cancer screening. A typical pipeline for lung cancer diagnosis involves pulmonary nodule detection, segmentation, and classification. Although traditional machine learning methods have been deployed in the previous years with great success, this literature review focuses on state-of-the-art deep learning methods. The objective is to extract key insights and methodologies from deep learning studies that exhibit high experimental results in this domain. This paper delves into the databases utilized, preprocessing steps applied, data augmentation techniques employed, and proposed methods deployed in studies with exceptional outcomes. The reviewed studies predominantly harness cutting-edge deep learning methodologies, encompassing traditional convolutional neural networks (CNNs) and advanced variants such as 3D CNNs, alongside other innovative approaches such as Capsule networks and transformers. The methods examined in these studies reflect the continuous evolution of deep learning techniques for pulmonary nodule detection, segmentation, and classification. The methodologies, datasets, and techniques discussed here collectively contribute to the development of more efficient computer-aided diagnostic systems, empowering radiologists and dfhealthcare professionals in the fight against this deadly disease.

Predicting invasion in early-stage ground-glass opacity pulmonary adenocarcinoma: a radiomics-based machine learning approach

BackgroundTo design a pulmonary ground-glass nodules (GGN) classification method based on computed tomography (CT) radiomics and machine learning for prediction of invasion in early-stage ground-glass opacity (GGO) pulmonary adenocarcinoma.MethodsThis retrospective study included pulmonary GGN patients who were histologically confirmed to have adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), or invasive adenocarcinoma cancer (IAC) from 2020 to 2023. CT images of all patients were automatically segmented and 107 radiomic features were obtained for each patient. Classification models were developed using random forest (RF) and cross-validation, including three one-versus-others models and one three-class model. For each model, features were ranked by normalized Gini importance, and a minimal subset was selected with a cumulative importance exceeding 0.9. These selected features were then used to train the final models. The models’ performance metrics, including area under the curve (AUC), accuracy, sensitivity, and specificity, were computed. AUC and accuracy were compared to determine the final optimal method.ResultsThe study comprised 193 patients (mean age 54 ± 11 years, 65 men), including 65 AIS, 54 MIA, and 74 IAC, divided into one training cohort (N = 154) and one test cohort (N = 39). The final three-class RF model outperformed three individual one-versus-others models in distinguishing each class from the other two. For the multiclass classification model, the AUC, accuracy, sensitivity, and specificity were 0.87, 0.79, 0.62, and 0.88 for AIS; 0.90, 0.79, 0.54, and 0.89 for MIA; and 0.87, 0.69, 0.73, and 0.67 for IAC, respectively.ConclusionsA radiomics-based multiclass RF model could effectively differentiate three types of pulmonary GGN, which enabled early diagnosis of GGO pulmonary adenocarcinoma.

Fully automated classification of pulmonary nodules in positron emission tomography-computed tomography imaging using a two-stage multimodal learning approach.

Lung cancer is a malignant tumor, for which pulmonary nodules are considered to be significant indicators. Early recognition and timely treatment of pulmonary nodules can contribute to improving the survival rate of patients with cancer. Positron emission tomography-computed tomography (PET/CT) is a noninvasive, fusion imaging technique that can obtain both functional and structural information of lung regions. However, studies of pulmonary nodules based on computer-aided diagnosis have primarily focused on the nodule level due to a reliance on the annotation of nodules, which is superficial and unable to contribute to the actual clinical diagnosis. The aim of this study was thus to develop a fully automated classification framework for a more comprehensive assessment of pulmonary nodules in PET/CT imaging data. We developed a two-stage multimodal learning framework for the diagnosis of pulmonary nodules in PET/CT imaging. In this framework, Stage I focuses on pulmonary parenchyma segmentation using a pretrained U-Net and PET/CT registration. Stage II aims to extract, integrate, and recognize image-level and feature-level features by employing the three-dimensional (3D) Inception-residual net (ResNet) convolutional block attention module architecture and a dense-voting fusion mechanism. In the experiments, the proposed model's performance was comprehensively validated using a set of real clinical data, achieving mean scores of 89.98%, 89.21%, 84.75%, 93.38%, 86.83%, and 0.9227 for accuracy, precision, recall, specificity, F1 score, and area under curve values, respectively. This paper presents a two-stage multimodal learning approach for the automatic diagnosis of pulmonary nodules. The findings reveal that the main reason for limiting model performance is the nonsolitary property of nodules in pulmonary nodule diagnosis, providing direction for future research.

VSNet: classification of pulmonary nodules in 3D using vision transformer and sequence spatial attention mechanism

VSNet: classification of pulmonary nodules in 3D using vision transformer and sequence spatial attention mechanism

Automated 3D convolutional neural network architecture design using genetic algorithm for pulmonary nodule classification

Cancer of the lungs is considered one of the primary causes of death among patients globally. Early detection contributes significantly to the success of pulmonary cancer treatment. To aid the pulmonary nodule classification, many models for the analysis of medical image utilizing deep learning have been developed. Convolutional neural network (CNN) recently, has attained remarkable results in various image classification tasks. Nevertheless, the CNNs performance is heavily dependent on their architectures which still heavily reliant on human domain knowledge. This study introduces a cutting-edge approach that leverages genetic algorithms (GAs) to automatically design 3D CNN architectures for differentiation between benign and malignant pulmonary nodules. The suggested algorithm utilizes the dataset of lung nodule analysis 2016 (LUNA16) for evaluation. Notably, our approach achieved exceptional model accuracy, with evaluations on the testing dataset yielding up to 95.977%. Furthermore, the algorithm exhibited high sensitivity, showcasing its robust performance in distinguishing between benign and malignant nodules. Our findings demonstrate the outstanding capabilities of the proposed algorithm and show an outstanding performance and attain a state of art solution in lung nodule classification.

Application of Artificial Intelligence in Neuroendocrine Lung Cancer Diagnosis and Treatment: A Systematic Review.

Neuroendocrine tumors (NETs) represent a heterogeneous group of neoplasms with diverse clinical presentations and prognoses. Accurate and timely diagnosis of these tumors is crucial for appropriate management and improved patient outcomes.In recent years, exciting advancements in artificial intelligence (AI) technologies have been revolutionizing medical diagnostics, particularly in the realm of detecting and characterizing pulmonary NETs, offering promisingavenuesfor improved patient care. This article aims to provide a comprehensive overview of the role of AI in diagnosing lung NETs. We discuss the current challenges associated with conventional diagnostic approaches, including histopathological examination and imaging modalities.Despite advancements in these techniques, accurate diagnosis remains challenging due to the overlapping features with other pulmonary lesions and the subjective interpretation of imaging findings. AI-based approaches, including machine learning and deep learning algorithms, have demonstrated remarkable potential in addressing these challenges. By leveraging large datasets of radiological images, histopathological samples, and clinical data, AI models can extract complex patterns and features that may not be readily discernible to human observers. Moreover, AI algorithms can continuously learn and improve from new data, leading to enhanced diagnostic accuracy and efficiency over time. Specific AI applications in the diagnosis of lung NETs include computer-aided detection and classification of pulmonary nodules on CT scans, quantitative analysis of PET imaging for tumor characterization, and integration of multi-modal data for comprehensive diagnostic assessments. These AI-driven tools hold promise for facilitating early detection, risk stratification, and personalized treatment planning in patients with lung NETs.

LDCT image biomarkers that matter most for the deep learning classification of indeterminate pulmonary nodules.

Continued improvement in deep learning methodologies has increased the rate at which deep neural networks are being evaluated for medical applications, including diagnosis of lung cancer. However, there has been limited exploration of the underlying radiological characteristics that the network relies on to identify lung cancer in computed tomography (CT) images. In this study, we used a combination of image masking and saliency activation maps to systematically explore the contributions of both parenchymal and tumor regions in a CT image to the classification of indeterminate lung nodules. We selected individuals from the National Lung Screening Trial (NLST) with solid pulmonary nodules 4-20 mm in diameter. Segmentation masks were used to generate three distinct datasets; 1) an Original Dataset containing the complete low-dose CT scans from the NLST, 2) a Parenchyma-Only Dataset in which the tumor regions were covered by a mask, and 3) a Tumor-Only Dataset in which only the tumor regions were included. The Original Dataset significantly outperformed the Parenchyma-Only Dataset and the Tumor-Only Dataset with an AUC of 80.80 ± 3.77% compared to 76.39 ± 3.16% and 78.11 ± 4.32%, respectively. Gradient-weighted class activation mapping (Grad-CAM) of the Original Dataset showed increased attention was being given to the nodule and the tumor-parenchyma boundary when nodules were classified as malignant. This pattern of attention remained unchanged in the case of the Parenchyma-Only Dataset. Nodule size and first-order statistical features of the nodules were significantly different with the average malignant and benign nodule maximum 3d diameter being 23mm and 12mm, respectively. We conclude that network performance is linked to textural features of nodules such as kurtosis, entropy and intensity, as well as morphological features such as sphericity and diameter. Furthermore, textural features are more positively associated with malignancy than morphological features.

A comparison study of artificial intelligence performance against physicians in benign–malignant classification of pulmonary nodules

Abstract Objectives To compare and evaluate the performance of artificial intelligence (AI) against physicians in classifying benign and malignant pulmonary nodules from computerized tomography (CT) images. Methods A total of 506 CT images with pulmonary nodules were retrospectively collected. The AI was trained using in-house software. For comparing the diagnostic performance of artificial intelligence and different groups of physicians in pulmonary nodules, statistical methods of receiver operating characteristic (ROC) curve and area under the curve (AUC) were analyzed. The nodules in CT images were analyzed in a case-by-case manner. Results The diagnostic accuracy of AI surpassed that of all groups of physicians, exhibiting an AUC of 0.88 alongside a sensitivity of 0.80, specificity of 0.84, and accuracy of 0.83. The area under the curve (AUC) of seven groups of physicians varies between 0.63 and 0.84. The sensitivity of the physicians within these groups varies between 0.4 and 0.76. The specificity of different groups ranges from 0.8 to 0.85. Furthermore, the accuracy of the seven groups ranges from 0.7 to 0.82. The professional insights for enhancing deep learning models were obtained through an examination conducted on a per-case basis. Conclusions AI demonstrated great potential in the benign–malignant classification of pulmonary nodules with higher accuracy. More accurate information will be provided by AI when making clinical decisions.

Nodule-CLIP: Lung nodule classification based on multi-modal contrastive learning

The latest developments in deep learning have demonstrated the importance of CT medical imaging for the classification of pulmonary nodules. However, challenges remain in fully leveraging the relevant medical annotations of pulmonary nodules and distinguishing between the benign and malignant labels of adjacent nodules. Therefore, this paper proposes the Nodule-CLIP model, which deeply mines the potential relationship between CT images, complex attributes of lung nodules, and benign and malignant attributes of lung nodules through a comparative learning method, and optimizes the model in the image feature extraction network by using its similarities and differences to improve its ability to distinguish similar lung nodules. Firstly, we segment the 3D lung nodule information by U-Net to reduce the interference caused by the background of lung nodules and focus on the lung nodule images. Secondly, the image features, class features, and complex attribute features are aligned by contrastive learning and loss function in Nodule-CLIP to achieve lung nodule image optimization and improve classification ability. A series of testing and ablation experiments were conducted on the public dataset LIDC-IDRI, and the final benign and malignant classification rate was 90.6%, and the recall rate was 92.81%. The experimental results show the advantages of this method in terms of lung nodule classification as well as interpretability.

BiCFormer: Swin Transformer based model for classification of benign and malignant pulmonary nodules

Pulmonary cancer is one of the most common and deadliest cancers worldwide, and the detection of benign and malignant nodules in the lungs can be an important aid in the early diagnosis of lung cancer. Existing convolutional neural networks inherit their limitations by extracting global contextual information, and in most cases prove to be less efficient in obtaining satisfactory results. Transformer-based deep learning methods have obtained good performance in different computer vision tasks, and this study attempts to introduce them into the task of computed tomography (CT) image classification of lung nodules. However, the problems of sample scarcity and difficulty of local feature extraction in this field. To this end, we are inspired by Swin Transformer to propose a model named BiCFormer for the task of classifying and diagnosing CT scan images of lung nodules. Specifically, first we introduce a multi-layer discriminator generative adversarial network module for data augmentation to assist the model in extracting features more accurately. Second, unlike the encoder of traditional Transformer, we divide the encoder part of BiCFormer into two parts: bi-level coordinate (BiC) and fast-partial-window (FPW). The BiC module has a part similar to the traditional channel attention mechanism is able to enhance the performance of the model, and is more able to enhance the representation of attention object features by aggregating features along two spatial directions. The BiC module also has a dynamic sparse attention mechanism that filters out irrelevant key-value pairs in rough regions, allowing the model to focus more on features of interest. The FPW module is mainly used to reduce computational redundancy and minimize feature loss. We conducted extensive experiments on the LIDC-IDRI dataset. The experimental results show that our model achieves an accuracy of 97.4% compared to other studies using this dataset for lung nodule classification, making it an effective and competitive method.

Enhanced lung cancer detection: Integrating improved random walker segmentation with artificial neural network and random forest classifier

BackgroundMedical image segmentation is a vital yet difficult job because of the multimodality of the acquired images. It is difficult to locate the polluted area before it spreads. MethodsThis research makes use of several machine learning tools, including an artificial neural network as well as a random forest classifier, to increase the system's reliability of pulmonary nodule classification. Anisotropic diffusion filtering is initially used to remove noise from a picture. After that, a modified random walk method is used to get the region of interest inside the lung parenchyma. Finally, the features corresponding to the consistency of the picture segments are extracted using texture-based feature extraction for pulmonary nodules. The final stage is to identify and classify the pulmonary nodules using a classifier algorithm. ResultsThe studies employ cross-validation to demonstrate the validity of the diagnosis framework. In this instance, the proposed method is tested using CT scan information provided by the Lung Image Database Consortium. A random forest classifier showed 99.6 percent accuracy rate for detecting lung cancer, compared to a artificial neural network's 94.8 percent accuracy rate. ConclusionsDue to this, current research is now primarily concerned with identifying lung nodules and classifying them as benign or malignant. The diagnostic potential of machine learning as well as image processing approaches are enormous for the categorization of lung cancer.

Proficiency evaluation of shape and WPT radiomics based on machine learning for CT lung cancer prognosis

BackgroundLung cancer is a fatal disease which has high occurrence and mortality rates, worldwide. Computed tomography imaging is being widely used by clinicians for detection of lung cancer. Radiomics extracted from medical images together with machine learning platform has enabled automated lung cancer diagnosis. Therefore, this study is proposed with the aim to efficiently apply radiomics and ML techniques to classify pulmonary nodules in CT images. Lung Image Data Consortium is utilized which contains 1018 CT lung cancer cases.ResultsRadiomics are extracted using Shape, Gray Level Co-occurrence Method, Gray Level Difference Method, and Gray Level Run Length Matrix along with Wavelet Packet Transform. To select a relevant set of features two techniques, Analysis of variance and Chi-square test, are applied. The classification of nodule into benign or malignant is evaluated by using state-of-art models: Support vector machine, Decision Trees, Ensemble Trees (BOCET, BACET, RUSBOCET), Ensemble Subspace KNN and Ensemble Subspace Discriminant. The results show that, BACET gives best AUROC (92.9%), MGSVM gives best accuracy (90.4%), FGSVM yields the best sensitivity (97.8%), MGSVM gives best precision (94.1%) and RUSBOCET gives best specificity (84%).ConclusionsThe results show that the proposed methodology can be successfully used for the classification of pulmonary nodules based on CT images. The outcome thus can help clinicians to reach better decision, treatments and early diagnosis.

Establishment and verification of a prediction model based on clinical characteristics and computed tomography radiomics parameters for distinguishing benign and malignant pulmonary nodules.

The radiographic classification of pulmonary nodules into benign versus malignant categories is a pivotal component of early lung cancer diagnosis. The present study aimed to investigate clinical and computed tomography (CT) clinical-radiomics nomogram for preoperative differentiation of benign and malignant pulmonary nodules. This retrospective study included 342 patients with pulmonary nodules who underwent high-resolution CT (HRCT) examination. We assigned them to a training dataset (n=239) and a validation dataset (n=103). There are 1781 tumor characteristics quantified by extracted features from the lesion segmented from patients' CT images. The features with poor reproducibility and high redundancy were removed. Then a least absolute shrinkage and selection operator (LASSO) logistic regression model with 10-fold cross-validation was used to further select features and build radiomics signatures. The independent predictive factors were identified by multivariate logistic regression. A radiomics nomogram was developed to predict the malignant probability. The performance and clinical utility of the clinical-radiomics nomogram was evaluated by receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). After dimension reduction by the LASSO algorithm and multivariate logistic regression, four radiomic features were selected, including original_shape_Sphericity, exponential_glcm_Maximum Probability, log_sigma_2_0_mm_3D_glcm_Maximum Probability, and ogarithm_firstorder_90Percentile. Multivariate logistic regression showed that carcinoembryonic antigen (CEA) [odds ratio (OR) 95% confidence interval (CI): 1.40 (1.09-1.88)], CT rad score [OR (95% CI): 2.74 (2.03-3.85)], and cytokeratin-19-fragment (CYFRA21-1) [OR (95% CI): 1.80 (1.14-2.94)] were independent influencing factors of malignant pulmonary nodule (all P<0.05). The clinical-radiomics nomogram combining CEA, CYFRA21-1 and radiomics features achieved an area of curve (AUC) of 0.85 and 0.76 in the training group and verification group for the prediction of malignant pulmonary nodules. The clinical-radiomics nomogram demonstrated excellent agreement and practicality, as evidenced by the calibration curve and DCA. The clinical-radiomics nomogram combined of CT-based radiomics signature, along with CYFRA21-1 and CEA, demonstrated strong predictive ability, calibration, and clinical usefulness in distinguishing between benign and malignant pulmonary nodules. The use of CT-based radiomics has the potential to assist clinicians in making informed decisions prior to biopsy or surgery while avoiding unnecessary treatment for non-cancerous lesions.

A comprehensive exploration of deep learning approaches for pulmonary nodule classification and segmentation in chest CT images

AbstractAccurately determining whether nodules on CT images of the lung are benign or malignant plays an important role in the early diagnosis and treatment of tumors. In this study, the classification and segmentation of benign and malignant nodules on CT images of the lung were performed using deep learning models. A new approach, C+EffxNet, is used for classification. With this approach, the features are extracted from CT images and then classified with different classifiers. In other phases of the study, a segmentation between benign and malignant was performed and, for the first time, a comparison of nodes was made during segmentation. The deep learning models InceptionV3, DenseNet121, and SeResNet101 were used as backbone models for feature extraction in the segmentation phase. In the classification phase, an accuracy of 0.9798, a precision of 0.9802, a recognition of 0.9798, an F1 score of 0.9798, and a kappa value of 0.9690 were achieved. During segmentation, the highest values of 0.8026 Jacard index and 0.8877 Dice coefficient were achieved.

ADGAN: Attribute-Driven Generative Adversarial Network for Synthesis and Multiclass Classification of Pulmonary Nodules.

Lung cancer is the leading cause of cancer-related deaths worldwide. According to the American Cancer Society, early diagnosis of pulmonary nodules in computed tomography (CT) scans can improve the five-year survival rate up to 70% with proper treatment planning. In this article, we propose an attribute-driven Generative Adversarial Network (ADGAN) for synthesis and multiclass classification of Pulmonary Nodules. A self-attention U-Net (SaUN) architecture is proposed to improve the generation mechanism of the network. The generator is designed with two modules, namely, self-attention attribute module (SaAM) and a self-attention spatial module (SaSM). SaAM generates a nodule image based on given attributes whereas SaSM specifies the nodule region of the input image to be altered. A reconstruction loss along with an attention localization loss (AL) is used to produce an attention map prioritizing the nodule regions. To avoid resemblance between a generated image and a real image, we further introduce an adversarial loss containing a regularization term based on KL divergence. The discriminator part of the proposed model is designed to achieve the multiclass nodule classification task. Our proposed approach is validated over two challenging publicly available datasets, namely LIDC-IDRI and LUNGX. Exhaustive experimentation on these two datasets clearly indicate that we have achieved promising classification accuracy as compared to other state-of-the-art methods.