Lung cancer screening based on low-dose CT (LDCT) has now been widely applied because of its effectiveness and ease of performance. Radiologists who evaluate a large LDCT screening images face enormous challenges, including mechanical repetition and boring work, the easy omission of small nodules, lack of consistent criteria, etc. It requires an efficient method for helping radiologists improve nodule detection accuracy with efficiency and cost-effectiveness. Many novel deep neural network-based systems have demonstrated the potential for use in the proposed technique to detect lung nodules. However, the effectiveness of clinical practice has not been fully recognized or proven. Therefore, the aim of this study to develop and assess a deep learning (DL) algorithm in identifying pulmonary nodules (PNs) on LDCT and investigate the prevalence of the PNs in China. Radiologists and algorithm performance were assessed using the FROC score, ROC-AUC, and average time consumption. Agreement between the reference standard and the DL algorithm in detecting positive nodules was assessed per-study by Bland-Altman analysis. The Lung Nodule Analysis (LUNA) public database was used as the external test. The prevalence of NCPNs was investigated as well as other detailed information regarding the number of pulmonary nodules, their location, and characteristics, as interpreted by two radiologists. Lung cancer screening has now been widely applied because of its effectiveness and ease of performance. More than 10 million chest CT scans were performed in the United States alone in 2012, highlighting the potential for this clinical scenario 1. Radiologists who evaluate a large number of low-dose CT (LDCT) screening images face enormous challenges, including mechanical repetition and boring work, the easy omission of small nodules, lack of consistent criteria, etc. 2-5. Artificial intelligence (AI) is showing rapid advantages and exciting achievements in the fields of imaging diagnosis and/or evaluation 6-12. AI detection of lung nodules has long been expected to be an effective assistant in daily clinical practice, especially for LDCT lung nodule screening. Thus far, many novel deep neural networkbased systems have demonstrated the potential for use in the proposed technique for helping radiologists improve nodule detection accuracy with efficiency and cost-effectiveness 13-18. However, the majority of the proposed systems were trained on CT scans from the Lung Image Database Consortium/Image Database Resource Initiative (LIDC-IDRI), the LUNA16 (Lung Nodule Analysis 2016) database and the ANODE09 (Automatic Nodule Detection 2009) database 19-24. The effectiveness in clinical practice has not been fully recognized or proven. From the previous study, the prevalence of pulmonary nodules (PNs) varies greatly in different populations, ranging from 13 to 58% 25-32. Different demographic features, selection criteria of participants, and the referral pattern of the study centre may explain such differences 27. In China, the incidence of non-c...
Background: The coronavirus disease 2019 (COVID-19) outbreak is spreading rapidly around the world.Purpose: We aimed to explore early warning information for patients with severe/critical COVID-19 based on quantitative analysis of chest CT images at the lung segment level.Materials and Methods: A dataset of 81 patients with coronavirus disease 2019 (COVID-19) treated at Wuhan Wuchang hospital in Wuhan city from 21 January 2020 to 14 February 2020 was retrospectively analyzed, including ordinary and severe/critical cases. The time course of all subjects was divided into four stages. The differences in each lobe and lung segment between the two groups at each stage were quantitatively analyzed using the percentage of lung involvement (PLI) in order to investigate the most important segment of lung involvement in the severe/critical group and its corresponding time point.Results: Lung involvement in the ordinary and severe/critical groups reached a peak on the 18th and 14th day, respectively. In the first stage, PLIs in the right middle lobe and the left superior lobe between the two groups were significantly different. In the second stage and the fourth stage, there were statistically significant differences between the two groups in the whole lung, right superior lobe, right inferior lobe and left superior lobe. The rapid progress of the lateral segment of the right middle lobe on the second day and the anterior segment of the right upper lobe on the 13th day may be a warning sign for severe/critical patients. Age was the most important demographic characteristic of the severe/critical group.Conclusion: Quantitative assessment based on the lung segments of chest CT images provides early warning information for potentially severe/critical patients.
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