ABSTRACT
BACKGROUND: Outside a screening program, early-stage lung cancer is generally diagnosed after the detection of incidental nodules in clinically ordered chest CT scans. Despite the advances in artificial intelligence (AI) systems for lung cancer detection, clinical validation of these systems is lacking in a non-screening setting. METHOD: We developed a deep learning-based AI system and assessed its performance for the detection of actionable benign nodules (requiring follow-up), small lung cancers, and pulmonary metastases in CT scans acquired in two Dutch hospitals (internal and external validation). A panel of five thoracic radiologists labeled all nodules, and two additional radiologists verified the nodule malignancy status and searched for any missed cancers using data from the national Netherlands Cancer Registry. The detection performance was evaluated by measuring the sensitivity at predefined false positive rates on a free receiver operating characteristic curve and was compared with the panel of radiologists. RESULTS: On the external test set (100 scans from 100 patients), the sensitivity of the AI system for detecting benign nodules, primary lung cancers, and metastases is respectively 94.3% (82/87, 95% CI: 88.1-98.8%), 96.9% (31/32, 95% CI: 91.7-100%), and 92.0% (104/113, 95% CI: 88.5-95.5%) at a clinically acceptable operating point of 1 false positive per scan (FP/s). These sensitivities are comparable to or higher than the radiologists, albeit with a slightly higher FP/s (average difference of 0.6). CONCLUSIONS: The AI system reliably detects benign and malignant pulmonary nodules in clinically indicated CT scans and can potentially assist radiologists in this setting.
Early-stage lung cancer can be diagnosed after identifying an abnormal spot on a chest CT scan ordered for other medical reasons. These spots or lung nodules can be overlooked by radiologists, as they are not necessarily the focus of an examination and can be as small as a few millimeters. Software using Artificial Intelligence (AI) technology has proven to be successful for aiding radiologists in this task, but its performance is understudied outside a lung cancer screening setting. We therefore developed and validated AI software for the detection of cancerous nodules or non-cancerous nodules that would need attention. We show that the software can reliably detect these nodules in a non-screening setting and could potentially aid radiologists in daily clinical practice.
ABSTRACT
We prospectively studied the feasibility and effectiveness of sputum induction in obtaining good quality sputum and its subsequent bacterial yield in children with clinically suspected acute lower-respiratory-tract infection (aLRTI). Good quality sputum was collected in 89/98 (91%) patients. Sputum cultures revealed ≥1 bacterial pathogens in 22 cases (25%). Adverse events were infrequent and mild (6%). Sputum induction is feasible in young children and leads to an increased number of etiological diagnoses of aLRTI.
ABSTRACT
KEY CLINICAL MESSAGE: We report a case of a successful embolization of a mycotic aneurysm of the left uterine artery in the puerperium after a neglected perforated appendicitis. A mycotic aneurysm, meaning an infection of the vessel wall which leads to an aneurysmatic dilatation of the vessel, is potentially life threatening if rupture occurs.
ABSTRACT
This brief report describes the radiographic images of a 29-year-old man with asymptomatic sarcoidosis. On a CT-scan a coalescent granuloma with a central core and peripheral nodules mimics a globular cluster galaxy; therefore it is called 'galaxy sign'. This is a classic finding in a granulomatous disease like sarcoidosis.
Subject(s)
Granuloma, Respiratory Tract/diagnostic imaging , Sarcoidosis/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Diagnosis, Differential , Humans , MaleABSTRACT
Stapled hemorrhoidopexy is a surgical procedure used worldwide for the treatment of grade III and IV hemorrhoids in all age groups. However, life-threatening complications occur occasionally. The following case report describes the development of pelvic sepsis after stapled hemorrhoidopexy. A literature review of techniques used to manage major septic complications after stapled hemorrhoidopexy was performed. There is no standardized treatment currently available. Stapled hemorrhoidopexy is a safe, effective and time-efficient procedure in the hands of experienced colorectal surgeons.
