Machine learning in differentiating pulmonary invasive adenocarcinoma from non-invasive adenocarcinoma manifested as pure ground-glass nodule / 中国医学影像技术

Objective: To investigate the value of machine learning model based on radiomic features in differentiating pulmonary invasive adenocarcinoma from non-invasive adenocarcinoma manifested as pure ground-glass nodule (pGGN). Methods: A total of 87 lung adenocarcinomas CT presented as pGGN were analyzed retrospectively, including 32 cases with invasive adenocarcinoma (IAC) and 55 cases with non-IAC (17 adenocarcinomas in-situ [AIS] and 38 minimally invasive adenocarcinomas [MIA]). The software ITK-SNAP was used to draw ROI, and the radiomic features were extracted using A.K. analysis software. After screening the significant characteristic parameters, the feature dimensionality reduction was conducted with Spearman analysis and Lasso regression. The final feature parameters were selected to construct three machine learning models, including support vector machine (SVM), random forest (RF) and logistics regression (LR). Then 10-fold cross validation was used to get the optimal model, and ROC curve was drawn to evaluate the performance of 3 models. Results: A total of 396 radiomic features were extracted, and 19 features were finally obtained after feature screening. Machine learning models SVM, RF and LR could effectively distinguish IAC from non-IAC, with the accuracies of 93.30%, 86.70% and 83.30%, and AUC of 0.94, 0.92 and 0.83 respectively. Conclusion: Machine learning models based on radiomic features have good classified performances, which can effectively distinguish IAC from non-IAC manifested as pGGN preoperation.

DiagnosticvalueofDWIwithultrahighbvalueinpredictionofaggressiveprostatecancer / 实用放射学杂志

Objective ToinvestigatethediagnosticvalueofADC withhigherbvaluefortheaggressivenessofprostatecancer. Methods 52patientswithpathologicallyprovedprostatecarcinomawerestudiedretrospectively.AllpatientsunderwentroutineMRI andDWIwithbvalueof1000and2000s/mm2.Accordingtothelocationoflesionfrombiopsyreport,aROIwasdrawnonADC mapatcancerousfociwithlowT2WIandhighDWIsignalintensityrespectivelyandtheADCvalueswerecalculated.Fociwereclassifiedinto highriskgroup(Gleasonscore≥8)andlow-intermediateriskgroup(Gleasonscore≤7).TheADCvaluesatb=1000or2000s/mm2between thetwogroupswerecomparedbyttest.ROCcurvewasusedtodeterminetheabilityofdifferentb-values.Relationshipsbetween meanADCvaluesinfociatb=1000or2000s/mm2andtumorGleasonscorewereassessedusingthe S pear m an test.Results Thereweresignificantdifferencesbetweenthehigh-riskgroupandthelow-intermediategroup(P<0.05)undertwob-values(b=1000s/mm2 andb=2000s/mm2).TheareaundertheROCcurveofb=1000s/mm2andb=2000s/mm2 ADCvaluesindifferentiatingthetwo groupswas0.858(P<0.05)and0.902(P<0.05)respectively,andnosignificantdifferencewasobservedintheAUCofbothgroups(P=0.222). ADCvaluesoftumorregionswerenegativecorrelatedwithtumorGleasonscoreat1000s/mm2(r=-0.709,P<0.05)and2000s/mm2 (r=-0.814,P<0.05)respectively.Although,nosignificantdifferencewasobservedinthecorrelationcoefficient(ρ)betweentwo groups(P=02.09).Conclusion ADCvaluesofbothb=1000and2000s/mm2havecorrelationwithGleasonscores.Thediagnosticperformanceof highb-value(2000s/mm2)ADCissuperiortonormalb-value(b=1000s/mm2)ADCinassessmentoftumoraggressiveness.

Feasibility of single hole thoracoscopy of pleural fibreboard end-arterectomy in treatment of chronic tuberculous empyema / 中国内镜杂志

Objective To discuss the feasibility of single hole thoracoscopy of pleural fibreboard endarterectomy surgical treatment on chronic tuberculous empyema. Methods Retrospective analysis of minimally invasive treatment of 52 cases of chronic tuberculous empyema form January 2013 to May 2016, 50 cases applied single hole thoracoscopy surgery, video-assisted mini-thoracoscopy for another 2 cases. Results There was no death, operation time 60 ~ 240 min, average 160 min, bleeding 150 ~ 2000 ml, average 350 ml, postoperative chest tube drainage time 3 ~ 21 d, average 7 d, postoperative persistent leakage in 3 patients, 3 cases of atelectasis, incisional infection in 1 case, pleural effusion in 1 case, 3 cases of arrhythmia. All the cured patients are received the corresponding treatment, the follow-up of 3 ~ 36 m, the chest CT scan show no atelectasis. Conclusion Under the condition of strict selection of indication, single hole thoracoscopy of pleural fibreboard endarterectomy in treatment of chronic tuberculous empyema is safe and feasible, so it is worthy of making further clinical promotion and application.