Supervised training models with or without manual lesion delineation outperform clinicians in distinguishing pulmonary cryptococcosis from lung adenocarcinoma on chest CT

Author:

Li Yun1ORCID,Chen Deyan2,Liu Shuyi1,Lin Junfeng1,Wang Wei34ORCID,Huang Jinhai1,Tan Lunfang1,Liang Lina1,Wang Zhufeng1,Peng Kang1,Li Qiasheng1,Jian Wenhua1,Zhang Youwen5,Peng Chengbao2,Chen Huai6,Zhang Xia2,Zheng Jinping1

Affiliation:

1. National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health the First Affiliated Hospital of Guangzhou Medical University Guangzhou China

2. Shenyang Neusoft Intelligent Medical Technology Research Institute Co., Ltd Shenyang China

3. School of Biomedical Sciences and Engineering South China University of Technology, Guangzhou International Campus Guangzhou China

4. Department of Information Zhujiang Hospital, Southern Medical University Guangzhou China

5. Department of Neurology Gaozhou People's Hospital Gaozhou China

6. Department of Radiology the Second Affiliated Hospital of Guangzhou Medical University Guangzhou China

Abstract

AbstractBackgroundThe role of artificial intelligence (AI) in the discrimination between pulmonary cryptococcosis (PC) and lung adenocarcinoma (LA) warrants further research.ObjectivesTo compare the performances of AI models with clinicians in distinguishing PC from LA on chest CT.MethodsPatients diagnosed with confirmed PC or LA were retrospectively recruited from three tertiary hospitals in Guangzhou. A deep learning framework was employed to develop two models: an undelineated supervised training (UST) model utilising original CT images, and a delineated supervised training (DST) model utilising CT images with manual lesion annotations provided by physicians. A subset of 20 cases was randomly selected from the entire dataset and reviewed by clinicians through a network questionnaire. The sensitivity, specificity and accuracy of the models and the clinicians were calculated.ResultsA total of 395 PC cases and 249 LA cases were included in the final analysis. The internal validation results for the UST model showed a sensitivity of 85.3%, specificity of 81.0%, accuracy of 83.6% and an area under the curve (AUC) of 0.93. Similarly, the DST model exhibited a sensitivity of 88.2%, specificity of 88.1%, accuracy of 88.2% and an AUC of 0.94. The external validation of the two models yielded AUC values of 0.74 and 0.77, respectively. The average sensitivity, specificity and accuracy of 102 clinicians were determined to be 63.1%, 53.7% and 59.3%, respectively.ConclusionsBoth models outperformed the clinicians in distinguishing between PC and LA on chest CT, with the UST model exhibiting comparable performance to the DST model.

Funder

National Key Research and Development Program of China

Publisher

Wiley

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