Background
Accurate detection is essential for brain metastasis (BM) management, but manual identification is laborious. This study developed, validated, and evaluated a BM detection (BMD) system.
Methods
Five hundred seventy-three consecutive patients (10,448 lesions) with newly diagnosed BMs and 377 patients without BMs were retrospectively enrolled to develop a multi-scale cascaded convolutional network using 3D-enhanced T1-weighted MR images. BMD was validated using a prospective validation set comprising an internal set (46 patients with 349 lesions; 44 patients without BMs) and three external sets (102 patients with 717 lesions; 108 patients without BMs). The lesion-based detection sensitivity and the number of false positives (FPs) per patient were analyzed. The detection sensitivity and reading time of three trainees and three experienced radiologists from three hospitals were evaluated using the validation set.
Results
The detection sensitivity and FPs were 95.8% and 0.39 in the test set, 96.0% and 0.27 in the internal validation set, and ranged from 88.9% to 95.5% and 0.29 to 0.66 in the external sets. The BMD system achieved higher detection sensitivity (93.2% [95% CI, 91.6–94.7%]) than all radiologists without BMD (ranging from 68.5% [95% CI, 65.7–71.3%] to 80.4% [95% CI, 78.0–82.8%], all P < 0.001). Radiologist detection sensitivity improved with BMD, reaching 92.7% to 95.0%. The mean reading time was reduced by 47% for trainees and 32% for experienced radiologists assisted by BMD relative to that without BMD.
Conclusions
BMD enables accurate BM detection. Reading with BMD improves radiologists’ detection sensitivity and reduces their reading times.
IntroductionThis study aimed to investigate the relationship among teacher enthusiasm and teacher self-efficacy, grit, and teacher psychological well-being among Chinese English as a foreign language (EFL) teachers.MethodsA sample of 553 Chinese EFL teachers completed self-report measures of teacher enthusiasm, teacher self-efficacy, grit, and teacher psychological well-being. Confirmatory factor analysis was used to confirm the validity of the scales, and structural equation modeling was used to test the hypothesized model.ResultsThe results indicated that teacher self-efficacy and grit were positively associated with teacher psychological well-being, providing support for the importance of these teacher characteristics in promoting teacher well-being. Furthermore, teacher enthusiasm was found to have an indirect effect on teacher psychological well-being through the mediation of teacher grit, providing evidence for the importance of teacher motivation and engagement in promoting teacher well-being. The partial mediation model was found to be the best fitting model.DiscussionThese findings have important implications for the development of interventions and programs aimed at promoting teacher well-being in the context of EFL teaching.
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