CT成像特征的纵向变异性用于预测肺结节侵袭性:一个多中心研究
1Health Promotion Center, Jiangsu Province Hospital and the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Chinese journal of cancer research = Chung-kuo yen cheng yen chiu
|November 13, 2025
概括
使用多次低剂量计算机断层扫描 (LDCT) 扫描的新模型准确地预测了侵入性肺癌. 这种工具有助于减少肺癌查计划中的过度诊断.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 低剂量计算机断层扫描 (LDCT) 的肺癌查可能导致过度诊断.
- 从结节中准确预测侵袭性肺癌对于有效的查至关重要.
研究的目的:
- 开发和验证一个模型,利用多次LDCT扫描的纵向放射特征预测侵袭性肺癌.
- 解决和减轻肺癌查中的过度诊断问题.
主要方法:
- 对628名患有肺结节的患者进行了回顾性分析,他们接受了三次LDCT扫描.
- 开发一个多变量物流模型 (MCT-ILC),结合结节的特征和可变性.
- 在两个独立的队列 (n=252和n=269) 中进行外部验证,使用AUC,校准图表和决策曲线分析 (DCA).
主要成果:
- 使用11个因素的MCT-ILC模型,包括直径变量的标准偏差 (SD),显示出高的预测性能.
- 测试队列中的AUC分别为0.912和0.906,表现优于只有基线特征的模型.
- 该模型显示出优异的校准 (Brier分数为0.091和0.078) 并通过DCA在所有值保持了正的净收益.
结论:
- 开发的MCT-ILC模型准确地评估了肺结节的侵入性.
- 这个模型有可能在肺癌查中显著减少过度诊断.
- 该模型有效地对患者进行分类,识别超过90%的侵入性结节是高风险的.
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