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Updated: May 9, 2025

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全面与分层计算机辅助检测值的诊断性能,用于基于胸部X射线的肺结核查
Joowhan Sung1,2, Peter James Kitonsa2, Annet Nalutaaya2
1Johns Hopkins University School of Medicine, Division of Infectious Diseases, Baltimore, MD, USA.
medRxiv : the preprint server for health sciences
|April 29, 2025
概括
计算机辅助检测 (CAD) 软件在一般人群中对结核病 (TB) 查具有高准确性. 根据年龄和性别定制CAD值,进一步提高了结核病检测的准确性.
科学领域:
- 医疗成像医学成像
- 传染病诊断 传染病诊断 传染病诊断
- 公共卫生查 公共卫生查
背景情况:
- 计算机辅助检测 (CAD) 软件分析胸部X射线的结核病 (TB) 指标,提供异常分数.
- 由于数据有限,在不同人群中估计结核病查的CAD准确性是具有挑战性的,特别是对于得分低或没有症状的个体.
- 针对进一步测试的最佳CAD得分值可能因人群和个体特征而异.
研究的目的:
- 评估CAD (qXR v3) 在乌干达一般人口中检测结核病 (TB) 的准确性,无论症状如何.
- 将通用CAD值的诊断准确性与结核病查的年龄和/或性别分层值进行比较.
主要方法:
- 携带有CAD的便携式胸部X射线被用于查52835名15岁以上的乌干达人.
- 具有X射线分数≥0.1的参与者接受了Xpert Ultra的唾液测试.
- 诊断准确性估计使用各种假设关于结核病在得分<0.1个人的患病率,比较通用与分层CAD值.
主要成果:
- 在7219名具有有效Xpert Ultra结果的参与者中,382人 (5.3%) 检测出结核病阳性.
- 对于检测Xpert阳性结核病,CAD显示曲线下的估计面积 (AUC) 为0.928.
- 根据年龄和性别对CAD值进行分层,与普遍值相比,在95.4%的特异性下,敏感性从75.0%提高到77.1%.
结论:
- 在一般人群中,包括无症状个体中,CAD软件对结核病查的准确性比以前估计的更高.
- 根据年龄和性别等人口因素个性化CAD值可以提高诊断准确度.
- 分层值为结核病查提供了更有效和更为定制的方法.
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