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Published in: European Radiology 12/2020

01-12-2020 | Computed Tomography | Imaging Informatics and Artificial Intelligence

Discrimination between transient and persistent subsolid pulmonary nodules on baseline CT using deep transfer learning

Authors: Chuxi Huang, Wenhui Lv, Changsheng Zhou, Li Mao, Qinmei Xu, Xinyu Li, Li Qi, Fei Xia, Xiuli Li, Qirui Zhang, Longjiang Zhang, Guangming Lu

Published in: European Radiology | Issue 12/2020

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Abstract

Objectives

To develop and validate a deep learning model to discriminate transient from persistent subsolid nodules (SSNs) on baseline CT.

Methods

A cohort of 1414 SSNs, consisting of 319 transient SSNs in 168 individuals and 1095 persistent SSNs in 816 individuals, were identified on chest CT. The cohort was assigned by examination date into a development set of 996 SSNs, a tuning set of 212 SSNs, and a validation set of 206 SSNs. Our model was built by transfer learning, which was transferred from a well-performed deep learning model for pulmonary nodule classification. The performance of the model was compared with that of two experienced radiologists. Each nodule was categorized by Lung CT Screening Reporting and Data System (Lung-RADS) to further evaluate the performance and the potential clinical benefit of the model. Two methods were employed to visualize the learned features.

Results

Our model achieved an AUC of 0.926 on the validation set with an accuracy of 0.859, a sensitivity of 0.863, and a specificity of 0.858, and outperformed the radiologists. The model performed the best among Lung-RADS 2 nodules and maintained well performance among Lung-RADS 4 nodules. Feature visualization demonstrated the model’s effectiveness in extracting features from images.

Conclusions

The transfer learning model presented good performance on the discrimination between transient and persistent SSNs. A reliable diagnosis on nodule persistence can be achieved at baseline CT; thus, an early diagnosis as well as better patient care is available.

Key Points

• Deep learning can be used for the discrimination between transient and persistent subsolid nodules.
• A transfer learning model can achieve good performance when it is transferred from a model with a similar task.
• With the assistance of deep learning model, a reliable diagnosis on nodule persistence can be achieved at baseline CT, which can bring a better patient care strategy.
Appendix
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Literature
1.
go back to reference Henschke CI, Yankelevitz DF, Mirtcheva R, McGuinness G, McCauley D, Miettinen OS (2002) CT screening for lung cancer: frequency and significance of part-solid and nonsolid nodules. AJR Am J Roentgenol 178:1053–1057CrossRefPubMed Henschke CI, Yankelevitz DF, Mirtcheva R, McGuinness G, McCauley D, Miettinen OS (2002) CT screening for lung cancer: frequency and significance of part-solid and nonsolid nodules. AJR Am J Roentgenol 178:1053–1057CrossRefPubMed
2.
go back to reference Kim HY, Shim YM, Lee KS, Han J, Yi CA, Kim YK (2007) Persistent pulmonary nodular ground-glass opacity at thin-section CT: histopathologic comparisons. Radiology 245:267–275CrossRefPubMed Kim HY, Shim YM, Lee KS, Han J, Yi CA, Kim YK (2007) Persistent pulmonary nodular ground-glass opacity at thin-section CT: histopathologic comparisons. Radiology 245:267–275CrossRefPubMed
3.
go back to reference Nakata M, Saeki H, Takata I et al (2002) Focal ground-glass opacity detected by low-dose helical CT. Chest 121:1464–1467CrossRefPubMed Nakata M, Saeki H, Takata I et al (2002) Focal ground-glass opacity detected by low-dose helical CT. Chest 121:1464–1467CrossRefPubMed
4.
go back to reference Lee SM, Park CM, Goo JM et al (2010) Transient part-solid nodules detected at screening thin-section CT for lung cancer: comparison with persistent part-solid nodules. Radiology 255:242–251CrossRefPubMed Lee SM, Park CM, Goo JM et al (2010) Transient part-solid nodules detected at screening thin-section CT for lung cancer: comparison with persistent part-solid nodules. Radiology 255:242–251CrossRefPubMed
5.
go back to reference Oh JY, Kwon SY, Yoon HI et al (2007) Clinical significance of a solitary ground-glass opacity (GGO) lesion of the lung detected by chest CT. Lung Cancer 55:67–73CrossRefPubMed Oh JY, Kwon SY, Yoon HI et al (2007) Clinical significance of a solitary ground-glass opacity (GGO) lesion of the lung detected by chest CT. Lung Cancer 55:67–73CrossRefPubMed
6.
go back to reference Silva M, Sverzellati N, Manna C et al (2012) Long-term surveillance of ground-glass nodules: evidence from the MILD trial. J Thorac Oncol 7:1541–1546CrossRefPubMed Silva M, Sverzellati N, Manna C et al (2012) Long-term surveillance of ground-glass nodules: evidence from the MILD trial. J Thorac Oncol 7:1541–1546CrossRefPubMed
7.
go back to reference Yu JY, Lee B, Ju S et al (2012) Proportion and characteristics of transient nodules in a retrospective analysis of pulmonary nodules. Thorac Cancer 3:224–228CrossRefPubMed Yu JY, Lee B, Ju S et al (2012) Proportion and characteristics of transient nodules in a retrospective analysis of pulmonary nodules. Thorac Cancer 3:224–228CrossRefPubMed
8.
go back to reference Felix L, Serra-Tosio G, Lantuejoul S et al (2011) CT characteristics of resolving ground-glass opacities in a lung cancer screening programme. Eur J Radiol 77:410–416CrossRefPubMed Felix L, Serra-Tosio G, Lantuejoul S et al (2011) CT characteristics of resolving ground-glass opacities in a lung cancer screening programme. Eur J Radiol 77:410–416CrossRefPubMed
9.
go back to reference Park CM, Goo JM, Lee HJ, Lee CH, Chun EJ, Im JG (2007) Nodular ground-glass opacity at thin-section CT: histologic correlation and evaluation of change at follow-up. Radiographics 27:391–408CrossRefPubMed Park CM, Goo JM, Lee HJ, Lee CH, Chun EJ, Im JG (2007) Nodular ground-glass opacity at thin-section CT: histologic correlation and evaluation of change at follow-up. Radiographics 27:391–408CrossRefPubMed
11.
go back to reference Gould MK, Donington J, Lynch WR et al (2013) Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143:e93S–e120SCrossRefPubMedPubMedCentral Gould MK, Donington J, Lynch WR et al (2013) Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143:e93S–e120SCrossRefPubMedPubMedCentral
12.
go back to reference MacMahon H, Naidich DP, Goo JM et al (2017) Guidelines for management of incidental pulmonary nodules detected on CT images: from the Fleischner Society 2017. Radiology 284:228–243CrossRefPubMed MacMahon H, Naidich DP, Goo JM et al (2017) Guidelines for management of incidental pulmonary nodules detected on CT images: from the Fleischner Society 2017. Radiology 284:228–243CrossRefPubMed
13.
go back to reference Slatore CG, Wiener RS, Golden SE, Au DH, Ganzini L (2016) Longitudinal assessment of distress among veterans with incidental pulmonary nodules. Ann Am Thorac Soc 13:1983–1991CrossRefPubMed Slatore CG, Wiener RS, Golden SE, Au DH, Ganzini L (2016) Longitudinal assessment of distress among veterans with incidental pulmonary nodules. Ann Am Thorac Soc 13:1983–1991CrossRefPubMed
14.
go back to reference Diederich S, Hansen J, Wormanns D (2005) Resolving small pulmonary nodules: CT features. Eur Radiol 15:2064–2069CrossRefPubMed Diederich S, Hansen J, Wormanns D (2005) Resolving small pulmonary nodules: CT features. Eur Radiol 15:2064–2069CrossRefPubMed
15.
go back to reference Chung K, Ciompi F, Scholten ET et al (2018) Visual discrimination of screen-detected persistent from transient subsolid nodules: an observer study. PLoS One 13:e0191874CrossRefPubMedPubMedCentral Chung K, Ciompi F, Scholten ET et al (2018) Visual discrimination of screen-detected persistent from transient subsolid nodules: an observer study. PLoS One 13:e0191874CrossRefPubMedPubMedCentral
16.
17.
go back to reference Ardila D, Kiraly AP, Bharadwaj S et al (2019) End-to-end lung cancer screening with three-dimensional deep learning on low-dose chest computed tomography. Nat Med 25:954–961CrossRefPubMed Ardila D, Kiraly AP, Bharadwaj S et al (2019) End-to-end lung cancer screening with three-dimensional deep learning on low-dose chest computed tomography. Nat Med 25:954–961CrossRefPubMed
18.
go back to reference Nam JG, Park S, Hwang EJ et al (2019) Development and validation of deep learning-based automatic detection algorithm for malignant pulmonary nodules on chest radiographs. Radiology 290:218–228CrossRefPubMed Nam JG, Park S, Hwang EJ et al (2019) Development and validation of deep learning-based automatic detection algorithm for malignant pulmonary nodules on chest radiographs. Radiology 290:218–228CrossRefPubMed
19.
go back to reference Kermany DS, Goldbaum M, Cai W et al (2018) Identifying medical diagnoses and treatable diseases by image-based deep learning. Cell 172:1122–1131.e1129CrossRefPubMed Kermany DS, Goldbaum M, Cai W et al (2018) Identifying medical diagnoses and treatable diseases by image-based deep learning. Cell 172:1122–1131.e1129CrossRefPubMed
20.
go back to reference Tajbakhsh N, Shin JY, Gurudu SR et al (2016) Convolutional neural networks for medical image analysis: full training or fine tuning? IEEE Trans Med Imaging 35:1299–1312CrossRefPubMed Tajbakhsh N, Shin JY, Gurudu SR et al (2016) Convolutional neural networks for medical image analysis: full training or fine tuning? IEEE Trans Med Imaging 35:1299–1312CrossRefPubMed
21.
go back to reference Hansell DM, Bankier AA, MacMahon H, McLoud TC, Muller NL, Remy J (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246:697–722CrossRefPubMed Hansell DM, Bankier AA, MacMahon H, McLoud TC, Muller NL, Remy J (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246:697–722CrossRefPubMed
22.
go back to reference Kakinuma R, Noguchi M, Ashizawa K et al (2016) Natural history of pulmonary subsolid nodules: a prospective multicenter study. J Thorac Oncol 11:1012–1028CrossRefPubMed Kakinuma R, Noguchi M, Ashizawa K et al (2016) Natural history of pulmonary subsolid nodules: a prospective multicenter study. J Thorac Oncol 11:1012–1028CrossRefPubMed
25.
go back to reference Wang Y, Morariu VI, Davis LS (2018) Learning a Discriminative Filter Bank within a CNN for fine-grained recognition. IEEE Conference on Computer Vision and Pattern Recognition (CVPR). arXiv:1611.09932 Wang Y, Morariu VI, Davis LS (2018) Learning a Discriminative Filter Bank within a CNN for fine-grained recognition. IEEE Conference on Computer Vision and Pattern Recognition (CVPR). arXiv:1611.09932
26.
go back to reference van der Maaten L, Hinton G (2008) Visualizing data using t-SNE. J Mach Learn Res 9:2579–2605 van der Maaten L, Hinton G (2008) Visualizing data using t-SNE. J Mach Learn Res 9:2579–2605
27.
go back to reference Lee SH, Lee SM, Goo JM, Kim KG, Kim YJ, Park CM (2014) Usefulness of texture analysis in differentiating transient from persistent part-solid nodules (PSNs): a retrospective study. PLoS One 9:e85167CrossRefPubMedPubMedCentral Lee SH, Lee SM, Goo JM, Kim KG, Kim YJ, Park CM (2014) Usefulness of texture analysis in differentiating transient from persistent part-solid nodules (PSNs): a retrospective study. PLoS One 9:e85167CrossRefPubMedPubMedCentral
Metadata
Title
Discrimination between transient and persistent subsolid pulmonary nodules on baseline CT using deep transfer learning
Authors
Chuxi Huang
Wenhui Lv
Changsheng Zhou
Li Mao
Qinmei Xu
Xinyu Li
Li Qi
Fei Xia
Xiuli Li
Qirui Zhang
Longjiang Zhang
Guangming Lu
Publication date
01-12-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07071-6

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