A CT-based radiomics nomogram for the differentiation of pulmonary cystic echinococcosis from pulmonary abscess

Abstract

The purpose of this study was to establish a clinical prediction model for the differential diagnosis of pulmonary cystic echinococcosis (CE) and pulmonary abscess according to computed tomography (CT)-based radiomics signatures and clinical indicators. This is a retrospective single-centre study. A total of 117 patients, including 53 with pulmonary CE and 64 with pulmonary abscess, were included in our study and were randomly divided into a training set (n = 95) and validation set (n = 22). Radiomics features were extracted from CT images, a radiomics signature was constructed, and clinical indicators were evaluated to establish a clinical prediction model. Finally, a model combining imaging radiomics features and clinical indicators was constructed. The performance of the nomogram, radiomics signature and clinical prediction model was evaluated and validated with the training and test datasets, and then the three models were compared. The radiomics signature of this study was established by 25 features, and the radiomics nomogram was constructed by using clinical factors and the radiomics signature. Finally, the areas under the receiver operating characteristic curve (AUCs) for the training set and test set were 0.970 and 0.983, respectively. Decision curve analysis showed that the radiologic nomogram was better than the clinical prediction model and individual radiologic characteristic model in differentiating pulmonary CE from pulmonary abscess. The radiological nomogram and models based on clinical factors and individual radiomics features can distinguish pulmonary CE from pulmonary abscess and will be of great help to clinical diagnoses in the future.

Lung abscess: an update on the current knowledge and call for future investigations

“…Numerous case reports have been published, for instance cases describing the clinical course of patients with Lemierre's syndrome [19 ▪ ] or granulomatosis with polyangiitis [23 ▪ ,24 ▪ ,25 ▪ ] highlighting the many differential diagnoses to consider. A few case reports also described new diagnostic tools including radiomics and metagenomic NGS [29 ▪ ,35 ▪ ,36 ▪ ,37 ▪ ] which could inspire future studies. Regarding treatment, a few case reports have described new intervention techniques and treatment options [41 ▪ ,42 ▪ ].…”

“…Radiomics is a new method of imaging analysis that combines imaging characteristics and clinical data to help clinicians diagnose complex cases [28]. In a recent study, radiomics helped clinicians distinguish LA from parasitological cystic infections [29 ▪ ] whether radiomics is useful for distinguishing LA from other cavitating lesions remains unknown.…”