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Jia LL, Zhao JX, Pan NN, Shi LY, Zhao LP, Tian JH, Huang G. Artificial intelligence model on chest imaging to diagnose COVID-19 and other pneumonias: A systematic review and meta-analysis. Eur J Radiol Open 2022; 9:100438. [PMID: 35996746 PMCID: PMC9385733 DOI: 10.1016/j.ejro.2022.100438] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/16/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives When diagnosing Coronavirus disease 2019(COVID‐19), radiologists cannot make an accurate judgments because the image characteristics of COVID‐19 and other pneumonia are similar. As machine learning advances, artificial intelligence(AI) models show promise in diagnosing COVID-19 and other pneumonias. We performed a systematic review and meta-analysis to assess the diagnostic accuracy and methodological quality of the models. Methods We searched PubMed, Cochrane Library, Web of Science, and Embase, preprints from medRxiv and bioRxiv to locate studies published before December 2021, with no language restrictions. And a quality assessment (QUADAS-2), Radiomics Quality Score (RQS) tools and CLAIM checklist were used to assess the quality of each study. We used random-effects models to calculate pooled sensitivity and specificity, I2 values to assess heterogeneity, and Deeks' test to assess publication bias. Results We screened 32 studies from the 2001 retrieved articles for inclusion in the meta-analysis. We included 6737 participants in the test or validation group. The meta-analysis revealed that AI models based on chest imaging distinguishes COVID-19 from other pneumonias: pooled area under the curve (AUC) 0.96 (95 % CI, 0.94–0.98), sensitivity 0.92 (95 % CI, 0.88–0.94), pooled specificity 0.91 (95 % CI, 0.87–0.93). The average RQS score of 13 studies using radiomics was 7.8, accounting for 22 % of the total score. The 19 studies using deep learning methods had an average CLAIM score of 20, slightly less than half (48.24 %) the ideal score of 42.00. Conclusions The AI model for chest imaging could well diagnose COVID-19 and other pneumonias. However, it has not been implemented as a clinical decision-making tool. Future researchers should pay more attention to the quality of research methodology and further improve the generalizability of the developed predictive models.
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Key Words
- 2D, two-dimensional
- 3D, three-dimensional
- AI, artificial intelligence
- AUC, area under the curve
- Artificial Intelligence
- CNN, Convolutional neural network
- COVID-19
- COVID-19, Coronavirus disease 2019
- CRP, C-reactive protein
- CT, Computed tomography
- CXR, Chest X-Ray
- Diagnostic Imaging
- GGO, ground-glass opacities
- KNN, K-nearest neighbor
- LASSO, least absolute shrinkage and selection operator
- MEERS-COV, Middle East respiratory syndrome coronavirus
- ML, machine learning
- Machine learning
- PLR, negative likelihood ratio
- PLR, positive likelihood ratio
- Pneumonia
- ROI, regions of interest
- RT-PCR, Reverse transcriptase polymerase chain reaction
- SARS, severe acute respiratory syndrome
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SROC, summary receiver operating characteristic
- SVM, Support vector machine
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Affiliation(s)
- Lu-Lu Jia
- First Clinical School of Medicine, Gansu University of Chinese Medicine, Lanzhou 73000, China
| | - Jian-Xin Zhao
- First Clinical School of Medicine, Gansu University of Chinese Medicine, Lanzhou 73000, China
| | - Ni-Ni Pan
- First Clinical School of Medicine, Gansu University of Chinese Medicine, Lanzhou 73000, China
| | - Liu-Yan Shi
- First Clinical School of Medicine, Gansu University of Chinese Medicine, Lanzhou 73000, China
| | - Lian-Ping Zhao
- Department of Radiology, Gansu Provincial Hospital, Lanzhou 730000, China
| | - Jin-Hui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Gang Huang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou 730000, China
- Corresponding author.
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Hino T, Lee KS, Yoo H, Han J, Franks TJ, Hatabu H. Interstitial lung abnormality (ILA) and nonspecific interstitial pneumonia (NSIP). Eur J Radiol Open 2021; 8:100336. [PMID: 33796637 PMCID: PMC7995484 DOI: 10.1016/j.ejro.2021.100336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 12/19/2022] Open
Abstract
This review article aims to address mysteries existing between Interstitial Lung Abnormality (ILA) and Nonspecific Interstitial Pneumonia (NSIP). The concept and definition of ILA are based upon CT scans from multiple large-scale cohort studies, whereas the concept and definition of NSIP originally derived from pathology with evolution to multi-disciplinary diagnosis. NSIP is the diagnosis as Interstitial Lung Disease (ILD) with clinical significance, whereas only a part of subjects with ILA have clinically significant ILD. Eventually, both ILA and NSIP must be understood in the context of chronic fibrosing ILD and progressive ILD, which remains to be further investigated.
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Key Words
- AIP, acute interstitial pneumonia
- ATS/ERS, American Thoracic Society/European Respiratory Society
- BIP, bronchiolitis obliterans with interstitial pneumonia
- BOOP, bronchiolitis obliterans organizing pneumonia
- CT
- CTD, connective tissue disease
- Connective tissue disease (CTD)
- DIP, desquamative interstitial pneumonia
- GGO, ground-glass opacities
- GIP, giant cell interstitial pneumonia
- HRCT
- HRCT, high-resolution CT
- IIP, idiopathic interstitial pneumonia
- ILA, interstitial lung abnormality
- ILD, interstitial lung disease
- Interstitial lung abnormality (ILA)
- Interstitial lung disease (ILD)
- LIP, lymphoid interstitial pneumonia
- NSIP, nonspecific interstitial pneumonia
- Nonspecific interstitial pneumonia (NSIP)
- Pulmonary fibrosis
- RB-ILD, respiratory bronchiolitis-associated interstitial lung disease
- UIP, usual interstitial pneumonia
- fNSIP, fibrosing nonspecific interstitial pneumonia
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Affiliation(s)
- Takuya Hino
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 8128582, Japan
| | - Kyung Soo Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Republic of Korea
| | - Hongseok Yoo
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Republic of Korea
| | - Joungho Han
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Republic of Korea
| | - Teri J Franks
- Pulmonary & Mediastinal Pathology, Department of Defense, The Joint Pathology Center, Silver Spring, MD, USA
| | - Hiroto Hatabu
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Saitoh Y, Miyazaki M, Arai N, Takahashi Y. Pneumomediastinum while using mechanical insufflation-exsufflation after recovery from riluzole-induced interstitial lung disease. eNeurologicalSci 2021; 22:100326. [PMID: 33598572 PMCID: PMC7868606 DOI: 10.1016/j.ensci.2021.100326] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/21/2021] [Accepted: 01/31/2021] [Indexed: 11/24/2022] Open
Abstract
We, herein, report a 61-year-old male patient with amyotrophic lateral sclerosis (ALS) complicated pneumomediastinum while using mechanical insufflation-exsufflation (MI-E) after recovery from riluzole (RZ)-induced interstitial lung disease (RZ-ILD). After the treatment of RZ-ILD, he required non-invasive mechanical ventilation (NIV) at minimal pressure settings and MI-E to manage ALS-related breathing and airway-clearance issues, respectively. After a while, he developed progressive worsening dyspnoea, and chest computed tomography revealed extensive pneumomediastinum that had spread to the area surrounding the oesophagus, the retrosternal space, and the pericardial space. He was treated with immediate discontinuation of MI-E; however, he had to keep using NIV to support his severe respiratory muscle involvement. Pneumomediastinum gradually reduced in size and no recurrence of pneumomediastinum occurred. The clinical course of our patient suggests that excessive coughing associated with MI-E combined with his previous RZ-ILD, which potentially renders his lungs vulnerable to airway pressure, may have been the aetiological factors for secondary pneumomediastinum, i.e. barotrauma. Clinicians should be aware of the risk of pneumomediastinum while using MI-E in patients with ALS, who have other pre-existing risk factors for pneumomediastinum, such as drug-induced ILD in our case.
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Key Words
- ALS, amyotrophic lateral sclerosis
- Amyotrophic lateral sclerosis
- Barotrauma
- COPD, chronic obstructive pulmonary disease
- CT, computed tomography
- GGO, ground-glass opacities
- ILD, interstitial lung disease
- Interstitial lung disease
- KL-6, Krebs von den Lungen-6
- MI-E, mechanical insufflation-exsufflation
- Mechanical insufflation-exsufflation
- NIV, non-invasive mechanical ventilation
- Pneumomediastinum
- RZ, riluzole
- RZ-ILD, riluzole-induced interstitial lung disease
- Riluzole
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Affiliation(s)
- Yuji Saitoh
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo 187-8551, Japan
| | - Masayuki Miyazaki
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo 187-8551, Japan
| | - Nobuaki Arai
- Department of General Thoracic Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo 187-8551, Japan
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Kono M, Nakamura Y, Oyama Y, Saito G, Koyanagi Y, Miyashita K, Tsutsumi A, Enomoto Y, Kobayashi T, Miki Y, Hashimoto D, Enomoto N, Colby TV, Suda T, Nakamura H. IgG4-related disease presenting with combined pulmonary fibrosis and emphysema (CPFE). Respir Med Case Rep 2018; 25:257-260. [PMID: 30302309 PMCID: PMC6175766 DOI: 10.1016/j.rmcr.2018.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 09/30/2018] [Indexed: 01/07/2023] Open
Abstract
A 64-year-old man was admitted to our hospital with an abnormal chest shadow. The patient was a current-smoker and had a past illness of autoimmune pancreatitis with a high serum level of IgG4, 348 mg/dL. Chest CT showed upper-lobe emphysema, and lower-lobe reticulation with honeycombing, suggestive of combined pulmonary fibrosis with emphysema (CPFE). Surgical lung biopsy was revealed a usual interstitial pneumonia pattern with marked infiltration of IgG4-positive plasma cells. The patient was diagnosed with IgG4 related disease (IgG4-RD) presenting with CPFE. Pulmonary manifestation was improved by corticosteroid therapy. IgG4-RD may be an underlying condition in patient with CPFE.
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Key Words
- AIP, autoimmune pancreatitis
- CPFE, Combined pulmonary fibrosis with emphysema
- CT, computed tomography
- CTD, connective tissue disease
- Combined pulmonary fibrosis and emphysema (CPFE)
- DIP, desquamative interstitial pneumonia
- DLco, diffusion capacity for carbon monoxide
- FEV1.0, forced vital capacity in 1 second
- FVC, forced vital capacity
- GGO, ground-glass opacities
- HE, hematoxylin-eosin
- HRCT, high-resolution CT
- IIP, idiopathic interstitial pneumonia
- IL, interleukin
- ILD, interstitial lung disease
- IPF, idiopathic pulmonary fibrosis
- IgG4-RD, IgG4-related disease
- IgG4-RLD, IgG4-related lung diseases
- IgG4-related disease (IgG4-RD)
- NSIP, nonspecific interstitial pneumonia
- PFT, pulmonary function tests
- RA, rheumatoid arthritis
- TGF, tissue growth factor
- UIP, usual interstitial pneumonia
- Usual interstitial pneumonia (UIP)
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Affiliation(s)
- Masato Kono
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
- Corresponding author. 2-12-12 Sumiyoshi, Nakaku, Hamamatsu, Shizuoka, 430-8558, Japan.
| | - Yutaro Nakamura
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
| | - Yoshiyuki Oyama
- Department of Respiratory Medicine, Sizuoka Saiseikai General Hospital, Japan
| | - Go Saito
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Yu Koyanagi
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Koichi Miyashita
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Akari Tsutsumi
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Yasunori Enomoto
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
| | - Takeshi Kobayashi
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Yoshihiro Miki
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Dai Hashimoto
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Noriyuki Enomoto
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
| | - Thomas V. Colby
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, AZ, USA
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
| | - Hidenori Nakamura
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
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