Weiya Shi1, Lingxiao Zhou2, Xueqing Peng2, He Ren2, Qinglei Wang3, Fei Shan1, Zhiyong Zhang1,3,4, Lei Liu2, Yuxin Shi1. 1. Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China. 2. Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China. 3. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China. 4. Headmaster's Office, Fudan University, Shanghai 200433, China.
Abstract
BACKGROUND: To characterize clinicoradiologic and radiomic features for identifying opportunistic pulmonary infections (OPIs) misdiagnosed as lung cancers in patients with human immunodeficiency virus (HIV). METHODS: Twenty-four HIV-infected patients who were misdiagnosed with lung cancers on CT images and had OPIs confirmed by pathological examination or integration of clinical and laboratory findings and 49 HIV-infected patients with lung cancers confirmed pathologically were included. Semiautomated segmentation of the lesion was implemented with an in-house software. The lesion boundary was adjusted manually by radiologists. A total of 99 nonenhanced-CT-based radiomic features were then extracted with PyRadiomics. The clinicoradiologic and radiomic features were compared between the OPI and cancer groups. RESULTS: In the OPI group, 19 patients (79.2%) had tuberculosis (TB) infections, 2 (8.3%) had nontuberculosis mycobacterium (NTM) infections, 2 (8.3%) had cryptococcus infections and 1 (4.2%) had a mixed infection of TB and NTM. There were significant differences in age, proportion of smokers, smoking index, highly active antiretroviral therapy (HAART) duration, CD4+ counts and CD4+/CD8+ ratio between the two groups (P=0.000, 0.012, 0.007, 0.002, 0.000, and 0.000, respectively). In peripheral-type lesions, the presence of pleural indentation was less common, and the presence of satellite lesions was more common in the OPI group (P=0.016 and 0.020, respectively). Four radiomic parameters of central-type lesions were significantly different, including large dependence high gray level emphasis (LDHGLE), skewness, inverse difference normalized (IDN) and kurtosis (P=0.008, 0.017, 0.017, and 0.017, respectively). However, neither CT features of central-type lesions nor radiomic parameters of peripheral-type lesions were significantly different between the two groups. CONCLUSIONS: Clinicoradiologic features together with radiomics may help identify OPIs mimicking lung cancers in HIV-infected patients.
BACKGROUND: To characterize clinicoradiologic and radiomic features for identifying opportunistic pulmonary infections (OPIs) misdiagnosed as lung cancers in patients with human immunodeficiency virus (HIV). METHODS: Twenty-four HIV-infected patients who were misdiagnosed with lung cancers on CT images and had OPIs confirmed by pathological examination or integration of clinical and laboratory findings and 49 HIV-infected patients with lung cancers confirmed pathologically were included. Semiautomated segmentation of the lesion was implemented with an in-house software. The lesion boundary was adjusted manually by radiologists. A total of 99 nonenhanced-CT-based radiomic features were then extracted with PyRadiomics. The clinicoradiologic and radiomic features were compared between the OPI and cancer groups. RESULTS: In the OPI group, 19 patients (79.2%) had tuberculosis (TB) infections, 2 (8.3%) had nontuberculosis mycobacterium (NTM) infections, 2 (8.3%) had cryptococcus infections and 1 (4.2%) had a mixed infection of TB and NTM. There were significant differences in age, proportion of smokers, smoking index, highly active antiretroviral therapy (HAART) duration, CD4+ counts and CD4+/CD8+ ratio between the two groups (P=0.000, 0.012, 0.007, 0.002, 0.000, and 0.000, respectively). In peripheral-type lesions, the presence of pleural indentation was less common, and the presence of satellite lesions was more common in the OPI group (P=0.016 and 0.020, respectively). Four radiomic parameters of central-type lesions were significantly different, including large dependence high gray level emphasis (LDHGLE), skewness, inverse difference normalized (IDN) and kurtosis (P=0.008, 0.017, 0.017, and 0.017, respectively). However, neither CT features of central-type lesions nor radiomic parameters of peripheral-type lesions were significantly different between the two groups. CONCLUSIONS: Clinicoradiologic features together with radiomics may help identify OPIs mimicking lung cancers in HIV-infected patients.
Authors: David M Hansell; Alexander A Bankier; Heber MacMahon; Theresa C McLoud; Nestor L Müller; Jacques Remy Journal: Radiology Date: 2008-01-14 Impact factor: 11.105
Authors: M D Seemann; A Staebler; T Beinert; H Dienemann; B Obst; M Matzko; C Pistitsch; M F Reiser Journal: Eur Radiol Date: 1999 Impact factor: 5.315
Authors: Eric A Engels; Robert J Biggar; H Irene Hall; Helene Cross; Allison Crutchfield; Jack L Finch; Rebecca Grigg; Tara Hylton; Karen S Pawlish; Timothy S McNeel; James J Goedert Journal: Int J Cancer Date: 2008-07-01 Impact factor: 7.396
Authors: Joshua Burrill; Christopher J Williams; Gillian Bain; Gabriel Conder; Andrew L Hine; Rakesh R Misra Journal: Radiographics Date: 2007 Sep-Oct Impact factor: 5.333
Authors: H Kim; S J Kang; G Y Suh; M P Chung; O J Kwon; C H Rhee; K J Jung; T S Kim; K S Lee Journal: Korean J Intern Med Date: 2001-12 Impact factor: 2.884