区域医疗中心人工智能辅助诊断肺结节的临床应用

Clinical application of artificial intelligence to lung nodules diagnosis in regional medical center

目的探讨区域医疗中心采用人工智能(AI)辅助诊断系统在肺结节多学科专家组(MDT)诊疗过程中的临床价值。方法回顾性分析本院2020年4~12月102例肺结节患者的临床资料,其中男57例、女45例,年龄36~90(48.8±11.6)岁。由MDT和AI系统分别进行诊断,比较AI与MDT结节检出差异率,并结合病理结果情况分析AI与MDT诊断的准确率:结果AI软件系统共检测出322个结节,医师人工检测出305个(P<0.05);其中113个结节获病理诊断,40例肺癌结节中AI报高危结节38例,敏感度为95.0%,73例良性结节中AI报高危结节25例,特异度为65.8%。MDT在肺癌结节中完全诊断正确,但在良性结节中仍有10例第一诊断考虑肺癌。结论AI辅助诊断系统在肺结节检出方面性能较强,但是在肺结节良恶性鉴别方面尚不能满足临床需求。在区域医疗中心,AI可以作为肺结节MDT诊疗有价值的辅助手段。

Objective To explore the efficacy of artificial intelligence(AI)detection on pulmonary nodule compared with multidisciplinary team(MDT)in regional medical center.Methods We retrospectively analyzed the clinical data of 102 patients with lung nodules in the Xiamen Fifth Hospital from April to December 2020.There were 57 males and 45 females at age of 36-90(48.8±11.6)years.The preoperative chest CT was imported into AI system to record the detected lung nodules.The detection rate of pulmonary nodules by AI system was calculated,and the sensitivity,specificity of AI in the different diagnosis of benign and malignant pulmonary was calculated and compared with manual film reading by MDT.Results A total of 322 nodules were detected by AI software system,and 305 nodules were manually detected by physicians(P<0.05).Among them,113 pulmonary nodules were diagnosed by pathologist.Thirtyeight of 40 lung cancer nodules were AI high-risk nodules,the sensitivity was 95.0%,and 25 of 73 benign nodules were AI high-risk nodules,the specificity was 65.8%.Lung cancer nodules were correctly diagnosed by MDT,but benign nodules were still considered as lung cancer at the first diagnosis in 10 patients.Conclusion AI assisted diagnosis system has strong performance in the detection of pulmonary nodules,but it can not content itself with clinical needs in the differentiation of benign and malignant pulmonary nodules.The artificial intelligence system can be used as an auxiliary tool for MDT to detect pulmonary nodules in regional medical center.