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Li Y, Xu Z, Lv X, Li C, He W, Lv Y, Hou D. Radiomics analysis of lung CT for multidrug resistance prediction in active tuberculosis: a multicentre study. Eur Radiol 2023; 33:6308-6317. [PMID: 37004571 PMCID: PMC10067016 DOI: 10.1007/s00330-023-09589-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 04/04/2023]
Abstract
OBJECTIVES Multidrug-resistant TB (MDR-TB) is a severe burden and public health threat worldwide. This study aimed to develop a radiomics model based on the tree-in-bud (TIB) sign and nodules and validate its predictive performance for MDR-TB. METHODS We retrospectively recruited 454 patients with proven active TB from two hospitals and classified them into three training and testing cohorts: TIB (n = 295, 102), nodules (n = 302, 97), and their combination (n = 261, 81). Radiomics features relating to TIB and nodules were separately extracted. The maximal information coefficient and recursive feature elimination were used to select informative features per the two signs. Two radiomics models were constructed to predict MDR-TB using a random forest classifier. Then, a combined model was built incorporating radiomics features based on these two signs. The capability of the models in the combined training and testing cohorts was validated with ROC curves. RESULTS Sixteen features were extracted from TIB and 15 from nodules. The AUCs of the combined model were slightly higher than those of the TIB model in the combined training cohort (0.911 versus 0.877, p > 0.05) and testing cohort (0.820 versus 0.786, p < 0.05) and similar to the performance of the nodules model in the combined training cohort (0.911 versus 0.933, p > 0.05) and testing cohort (0.820 versus 0.855, p > 0.05). CONCLUSIONS The CT-based radiomics models hold promise for use as a non-invasive tool in the prediction of MDR-TB. CLINICAL RELEVANCE STATEMENT Our study revealed that complementary information regarding MDR-TB can be provided by radiomics based on the TIB sign and nodules. The proposed radiomics models may be new markers to predict MDR in active TB patients. KEY POINTS • This is the first study to build, validate, and apply radiomics based on tree-in-bud sign and nodules for the prediction of MDR-TB. • The radiomics model showed a favorable performance for the identification of MDR-TB. • The combined model holds potential to be used as a diagnostic tool in routine clinical practice.
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Affiliation(s)
- Ye Li
- Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China
| | - Zexuan Xu
- Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China
| | - Xinna Lv
- Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China
| | - Chenghai Li
- Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China
| | - Wei He
- Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China
| | - Yan Lv
- Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China
| | - Dailun Hou
- Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China.
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Han D, Chen Y, Li X, Li W, Zhang X, He T, Yu Y, Dou Y, Duan H, Yu N. Development and validation of a 3D-convolutional neural network model based on chest CT for differentiating active pulmonary tuberculosis from community-acquired pneumonia. Radiol Med 2023; 128:68-80. [PMID: 36574111 PMCID: PMC9793822 DOI: 10.1007/s11547-022-01580-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 12/13/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE To develop and validate a 3D-convolutional neural network (3D-CNN) model based on chest CT for differentiating active pulmonary tuberculosis (APTB) from community-acquired pneumonia (CAP). MATERIALS AND METHODS Chest CT images of APTB and CAP patients diagnosed in two imaging centers (n = 432 in center A and n = 61 in center B) were collected retrospectively. The data in center A were divided into training, validation and internal test sets, and the data in center B were used as an external test set. A 3D-CNN was built using Keras deep learning framework. After the training, the 3D-CNN selected the model with the highest accuracy in the validation set as the optimal model, which was applied to the two test sets in centers A and B. In addition, the two test sets were independently diagnosed by two radiologists. The 3D-CNN optimal model was compared with the discrimination, calibration and net benefit of the two radiologists in differentiating APTB from CAP using chest CT images. RESULTS The accuracy of the 3D-CNN optimal model was 0.989 and 0.934 with the internal and external test set, respectively. The area-under-the-curve values with the 3D-CNN model in the two test sets were statistically higher than that of the two radiologists (all P < 0.05), and there was a high calibration degree. The decision curve analysis showed that the 3D-CNN optimal model had significantly higher net benefit for patients than the two radiologists. CONCLUSIONS 3D-CNN has high classification performance in differentiating APTB from CAP using chest CT images. The application of 3D-CNN provides a new automatic and rapid diagnosis method for identifying patients with APTB from CAP using chest CT images.
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Affiliation(s)
- Dong Han
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang West Rd, Xianyang, 712000 China
| | - Yibing Chen
- School of Information Science & Technology, Northwest University, Xi’an, 710127 Shaanxi China
| | - Xuechao Li
- Clinical Research Center, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, 712000 China
| | - Wen Li
- Department of Radiology, Baoji Central Hospital, Baoji, 721008 China
| | - Xirong Zhang
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang West Rd, Xianyang, 712000 China ,College of Medical Technology, Shaanxi University of Chinese Medicine, Xianyang, 712000 China
| | - Taiping He
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang West Rd, Xianyang, 712000 China ,College of Medical Technology, Shaanxi University of Chinese Medicine, Xianyang, 712000 China
| | - Yong Yu
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang West Rd, Xianyang, 712000 China ,College of Medical Technology, Shaanxi University of Chinese Medicine, Xianyang, 712000 China
| | - Yuequn Dou
- Respiratory Department, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, 712000 China
| | - Haifeng Duan
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang West Rd, Xianyang, 712000 China
| | - Nan Yu
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Weiyang West Rd, Xianyang, 712000, China.
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Zeng S, Mu J, Dai H, Peng M, Li W, Ao M, Huang J, Yang L. Artificial Intelligence assisted discrimination between pulmonary tuberculous nodules and solid lung cancer nodules. Clinical eHealth 2022. [DOI: 10.1016/j.ceh.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Yang G, Wen Y, Chen T, Xu C, Yuan M, Li Y. Comparison of pediatric empyema secondary to tuberculosis or non-tuberculosis community-acquired pneumonia in those who underwent surgery in high TB burden areas. Pediatr Pulmonol 2021; 56:3321-3331. [PMID: 34289260 DOI: 10.1002/ppul.25591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 07/05/2021] [Accepted: 07/19/2021] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Tuberculous empyema (TE) in children is common in high-TB burden and medical resource-limited areas. However, studies that evaluate the characteristics of TE in children are sparse. This study aimed to analyze the clinical features of pediatric TE receiving surgical intervention. METHODS We performed a retrospective study of children with empyema secondary to community-acquired pneumonia who underwent surgery in our institution. The clinical characteristics were compared between TE and empyema secondary non-tuberculosis infection (non-tuberculosis empyema, NTE). RESULTS One hundred patients were included (27 with TE and 73 with NTE). Stage 3 empyema occupied 81.5% and 45.2% of TE and NTE in this study. The TE children had older age, longer duration of illness, and milder symptoms. Pleural fluid culture was positive for Mycobacterium tuberculosis in 7.4% of patients with TE. Lymph node enlargement, lymph node calcification, and pleural nodules presented in TE with high specificity (93.2%, 98.6%, and 98.5%) but low sensitivity (33.3%, 14.8%, and 29.6%) on CT scan. Thoracoscopy surgery was performed in 14 (51.9%) in TE and 39 (53.4%) in NTE. Postoperative chest-tube indwelling time was longer (7.85 ± 5.00 vs. 4.89 ± 1.81 days, p < .001), and more patients had incomplete lung expansion after 3 months in TE. CONCLUSION Tuberculosis infection should be screened in management of children with empyema in high-TB burden areas. Pediatric TE usually presented at older age and with milder respiratory symptoms. Pleural biopsy during surgery is often necessary to confirm the cause of infection. Thoracotomy is still required in some pediatric TE or NTE with delayed treatment in medical resource-limited area.
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Affiliation(s)
- Gang Yang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yang Wen
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Ting Chen
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Chang Xu
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Miao Yuan
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuan Li
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Digestive Surgery, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Li K, Jiang Z, Zhu Y, Fan C, Li T, Ma W, He Y. A valuable computed tomography-based new diagnostic tool for severe chest lesions in active pulmonary tuberculosis: combined application of influencing factors. Sci Rep 2020; 10:2023. [PMID: 32029876 PMCID: PMC7005193 DOI: 10.1038/s41598-020-59041-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/23/2020] [Indexed: 12/30/2022] Open
Abstract
The objective of the present investigation was to explore the influencing factors and value of computed tomography (CT) for diagnosing severe chest lesions in active pulmonary tuberculosis (APTB). This retrospective investigation included 463 patients diagnosed with APTB. Relevant clinical features were collected. Patients were assigned to mild/moderate group or advanced group depending on the lesion severity on chest CT, severe chest CT lesion refers to the moderately dense or less diffuse lesion that exceeds the total volume of one lung, or the dense fusion lesion greater than one third of the volume of one lung, or the lesion with cavity diameter ≥4 cm. Independent risk factors for severe lesions were determined by univariate and multivariate logistic regression analyses, and the diagnostic efficiency of the risk factors was assessed by receiver operating characteristic curve (ROC). Chest CT demonstrated that there were 285 (61.56%) cases with severe lesions; multivariate Logistic regression analysis showed dust exposure [odds ratio (OR) = 4.108, 95% confidence interval (CI) 2.416–6.986], patient classification (OR = 1.792, 95% CI 1.067–3.012), age (OR = 1.018, 95% CI 1.005–1.030), and albumin-globulin ratio (OR = 0.179, 95% CI 0.084–0.383) to be independently correlated with severe lesions on chest CT. ROC curve analysis showed the cutoff values of age, albumin-globulin ratio and combined score to be 39 years, 0.918 and −0.085, respectively. The predictive value of combined score area under the curve 0.753 (95% CI 0.708–0.798) was higher than that of any single factor. The combined score of these four factors further improved the predictive efficacy.
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Affiliation(s)
- Kui Li
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.,Department of Infectious Diseases, Ankang Central Hospital, 85 South Jinzhou Road, Ankang, 725000, Shaanxi, China
| | - Zicheng Jiang
- Department of Infectious Diseases, Ankang Central Hospital, 85 South Jinzhou Road, Ankang, 725000, Shaanxi, China
| | - Yanan Zhu
- The Medical Imaging Centre, Ankang Central Hospital, 85 South Jinzhou Road, Ankang, 725000, Shaanxi, China
| | - Chuanqi Fan
- Department of Infectious Diseases, Ankang Central Hospital, 85 South Jinzhou Road, Ankang, 725000, Shaanxi, China
| | - Tao Li
- Department of Infectious Diseases, Ankang Central Hospital, 85 South Jinzhou Road, Ankang, 725000, Shaanxi, China
| | - Wenqi Ma
- Department of Ultrasound, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 West 5 Road, Xi'an, 710004, Shaanxi, China
| | - Yingli He
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.
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