RESUMO
Objective:To evaluate the value of a novel multiphase three-dimensional deep learning neural network of computer-aided diagnosis (CAD) used in LDCT lung cancer screening.Methods:Eight thousand eight hundred and fifty volunteers with 1 111 nodules were enrolled in the lung cancer screening from November of 2013 to December of 2017, and the baseline LDCT imaging data of volunteers accompanied with clinical information were retrospectively analyzed. All volunteers in this study were designed to receive LDCT test at least once. All the imaging of volunteers were read through the methods of visual detectioin (VD), CAD, and VD Combined CAD. The criteria of the true pulmonary nodule was determinated by the consistent opinion of two specialists in chest imaging（in case of disagreement, the decision should made by the third chief physician). In terms of the numbers, types or Lung-RADS categories of nodules, the detection rate, missed diagnosis rate and false positive rate of pulmonary nodules or lung cancer among three methods were compared, and the rates between groups were compared by χ 2test. Results:Compared with VD or CAD ,the detection rate of nodules in the CAD combined VD was significantly increased (95.7% , 94.2%, vs. 80.1% P<0.05 ), and the rate of missed diagnosis was significantly reduced (5.8%, 4.3% vs. 19.9% ，χ2=101.650, 128.500 ，P<0.05); Compared with VD, the methods of CAD or VD combined CAD significantly increased the the detection rates of Lung-RADS categories (χ2 =25.083,23.449, P=0.000, 0.000) or different types of nodules (χ2=6.955,6.821, P=0.031, 0.033), but there was no statistically significant difference between CAD and VD combined CAD for Lung-RADS categories and different types of nodules (all P>0.05); Compared with VD and VD combined CAD, the positive prediction rate of CAD for lung cancer was significantly reduced, and the rate of missed diagnosis and false positive rate were significantly increased, but there was no significant difference between VD and VD combined CAD in the prediction rate, missed diagnosis rate and false positive rate of lung cancer. Conclusion:The method of CAD combined VD can reduce the detection of false positive nodules and improve the detection rate of true pulmonary nodules,which is the preferred method using in LDCT lung cancer screening for city population.
RESUMO
Objective To study the proportion and sonographic features of various kinds of diseases in the polypoid lesions of the gallbladder (PLG) diagnosed by ultrasonography, and to explore the reliability of ultrasonography for the diagnosis of PLG. Methods A total of 556 cases of PLG diagnosed by ultrasonography were classified basing on the results of pathological examination. And the accordance rate between ultrasonography and pathological examination in the PLG with different size was analyzed. Results Among the 556 cases of PLG, 446 (80.2%) had cholesterol polyps, 86 (15.5%) adenomatous polyps, 18 (3.2%) inflammatory polyps, and 6 (1.1%) myoadenoma. In 97.3% of the cholesterol polyps, the diameter was less than 1.0 cm, and 64.6% of the cases had multiple polyps. In the cholesterol polyps, the accordance rate between ultrasonography and pathological examination was 91.3%. Of the adenomatous polyps, 61.6% had a diameter over 1.0 cm, and 34.0% showed atypical hyperplasia or malignancy. However, 25% of the malignancies were found in the adenomatous polyps with a diameter less than 1.0 cm. Conclusions More than 80% of PLG are cholesterol polyps and 15.5% are adenomatous polyps. Most of the PLG with malignant transformation sized over 1.0 cm in diameter. However, the adenomatous polyps with a diameter ranged from 0.7 to 0.9 cm also have malignant tendency. In the cholesterol polyps, the accordance rate between ultrasonography and pathological examination is 91.3%, showing that ultrasonography is reliable for the diagnosis of the disease.