A CT-Based Radiomic Signature for the Differentiation of Pulmonary Hamartomas from Carcinoid Tumors

Cangır, Ayten; Orhan, Kaan; Kahya, Yusuf; Yücemen, Ayşe Uğurum; Aktürk, İslam; Özakıncı, Hilal; Çoruh, Ayşegül Gürsoy; Sak, Serpil Dizbay

doi:10.3390/diagnostics12020416

Cited by 10 publications

(10 citation statements)

References 30 publications

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“…13,14,17,18 To the best of our knowledge, only one publication exhibited the possibility of radiomics approach based on contrast-enhanced CT (CECT) in differentiating pulmonary hamartoma and carcinoid; however, it did not explore whether CT radiomics extracted from unenhanced CT (UECT) have the possibility or not. 19 Therefore, the aim of this study was to investigate and compare the ability of CT radiomics between UECT and CECT in the distinguishment of NCH and PC.…”

mentioning

confidence: 99%

Differentiating Peripherally Located Pulmonary Noncalcified Hamartoma From Carcinoid Using CT Radiomics Approaches

Yang¹,

Li²,

Hou³

et al. 2023

J Comput Assist Tomogr

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Objective: This article aimed to differentiate noncalcified hamartoma from pulmonary carcinoid preoperatively using computed tomography (CT) radiomics approaches. Materials and Methods:The unenhanced CT (UECT) and contrast-enhanced CT (CECT) data of noncalcified hamartoma (n = 73) and pulmonary carcinoid (n = 54; typical/atypical carcinoid = 13/41) were retrospectively analyzed. The patients were randomly divided into the training and validation sets. A total of 396 radiomics features were extracted from UECTand CECT, respectively. The features were selected by using the minimum redundancy maximum relevance and the least absolute shrinkage and selection operator to construct a radiomics model. Clinical factors and radiomics features were integrated to build a nomogram model. The performance of clinical factors, radiomics, and nomogram models on the differential diagnosis between noncalcified hamartoma and carcinoid were investigated. Diagnostic performance of radiologists was also explored. Result:In regard to distinguishing noncalcified hamartoma from carcinoid, the areas under the receiver operating characteristic curves of the clinical, radiomics, and nomogram models were 0.88, 0.94, and 0.96 in the training set UECT, and were 0.85, 0.92, and 0.96 in the training set CECT, respectively. The areas under the curve of the 3 models were 0.89, 0.96, and 0.96 in the validation set UECT, and were 0.79, 0.90, and 0.94 in the validation set CECT, respectively. The nomogram model exhibited good calibration and was clinically useful by decision curve analysis. Nomogram did not show significant improvement compared with radiomics, neither for UECT nor for CECT. Diagnostic performance of radiologists was lower than both radiomics and nomogram model. Conclusions:Radiomics approaches may be useful in distinguishing peripheral pulmonary noncalcified hamartoma from carcinoid. Radiomics features extracted from CECT provided no significant benefit when compared with UECT.

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confidence: 99%

Differentiating Peripherally Located Pulmonary Noncalcified Hamartoma From Carcinoid Using CT Radiomics Approaches

Yang¹,

Li²,

Hou³

et al. 2023

J Comput Assist Tomogr

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“…Currently, it is considered that PHs can double their diameter over time, having a growth rate of 3.2±2.6 mm/year [ 4 ]. The “popcorn” or “comma-shaped” calcification or the presence of fat tissue are also typical for PHs on posteroanterior chest radiography/CT [ 7 , 11 ]. However, these features are absent in 30% of PHs cases [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…The “popcorn” or “comma-shaped” calcification or the presence of fat tissue are also typical for PHs on posteroanterior chest radiography/CT [ 7 , 11 ]. However, these features are absent in 30% of PHs cases [ 7 ]. In our study group, the largest PH size was 95 mm, while calcification was registered in only 14.81% of cases, probably due to the small size of the lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Commonly, they present as solitary nodules, measuring less than 4 cm in diameter, in thorax computed tomography (CT) images [ 4 ]. Additionally, a radiological pattern of “popcorn” or “comma-shaped” calcification, observed in 10–15% of cases, is highly suggestive of PH diagnosis [ 6 , 7 ]. According to PH location and size, patients can develop chronic cough, dyspnea, hemoptysis, chest pain, and obstructive pneumonia [ 1 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

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The clinicopathological challenges of symptomatic and incidental pulmonary hamartomas diagnosis

Grigoraș

Amălinei²,

Lovin³

et al. 2023

Rom J Morphol Embryol

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Pulmonary hamartomas (PHs) are the most common benign lung tumors. Usually, they are asymptomatic and incidentally discovered during assessment for other diseases or during the autopsy exam. In this context, we have performed a retrospective analysis of surgical resections in a 5-year series of patients diagnosed with PHs in the Clinic of Pulmonary Diseases, Iaşi, Romania, aiming to evaluate their clinicopathological features. A total of 27 patients with PH (40.74% males and 59.26% females) were evaluated. 33.33% of patients were asymptomatic, while the others exhibited variable symptoms, such as chronic cough, dyspnea, chest pain or weight loss. In most cases, PHs presented as solitary nodules, predominantly disposed in the right upper lobe (40.74% of cases), followed by the right lower lobe (33.34%), and left lower lobe (18.51%). The microscopic examination revealed a mixture of mature mesenchymal tissue, such as hyaline cartilage, adipose tissue, fibromyxoid tissue, and smooth muscle bundles, in variable proportions, associated with clefts of entrapped benign epithelium. A dominant adipose tissue component was observed in one case. PH was associated with a history of extrapulmonary cancer diagnosis, in one patient. Although considered benign lung tumors, PHs diagnosis and therapy may be challenging. Having in mind the possibility of recurrence or their occurrence as a part of specific syndromes, PHs should be thoroughly investigated for an appropriate patients' management. Their complex significance and the correlation with other types of lesions, including malignancies, may be further studied, by more extensive studies of surgical and necroptic cases.

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“…Noteworthy, Zegadło et al 25 using an iodine concentrations threshold of (12.11×100 g/cm 3 ) in the venous phase and Zhang and colleagues using a normalized-iodine concentrations threshold of 0.30 have reached a sensitivity of 96% and 93.8%, respectively, and a specificity of 63% and 85.7%, respectively, for differentiating malignant from benign pulmonary lesions, 27 but they studied a population without NEN. Cangir et al 29 studied 138 lesions (78 NENs and 60 HAs, 63% without fat tissue) and revealed that radiomics tumor features derived from CT images are useful to differentiate NENs from HAs, reaching high accuracy with the random forest and multi-layer perceptron method for both HAs and NENs (AUC=0.999) for the first model developed; however, in the test set, AUC lowered to 0.836 both for HAs and NENs when only HAs without fat-tissue were included.…”

Section: Discussionmentioning

confidence: 99%

Washout-Computed Tomography Discriminates Pulmonary “Fat-poor” Hamartomas From Neuroendocrine Neoplasms

Volterrani

Perrella

Bagnacci

et al. 2023

Journal of Thoracic Imaging

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Purpose: Pulmonary hamartomas (HAs) and neuroendocrine neoplasms (NENs) are often impossible to discriminate using high-resolution computed tomography (CT) as they share morphologic features. This challenge makes differential diagnosis crucial as HAs are invariably benign, whereas NENs must be considered malignant, thus requiring them to be evaluated for surgical excision. Our aim was, therefore, to develop a simple method to discriminate between pulmonary “fat-poor” HAs and NENs using contrast-enhanced CT (CECT). Materials and Methods: Between September 2015 and December 2021, 95 patients with a histologically proven diagnosis of lung NENs (74) and HAs (21) and who underwent a preoperative CECT scan were initially identified through a review of our pathologic and radiologic databases. Among these, 55 cases (18 HAs and 37 NENs), which have been studied with biphasic CECT, were ultimately selected and reviewed by 3 radiologists with different levels of experience, analyzing their morphologic and enhancement features. The enhancement analysis was performed by placing a region of interest within the lesion in noncontrast (NCp), postcontrast (PCp, 55 to 65 s after intravenous contrast injection), and delayed phases (Dp, 180 to 300 s). A subgroup of 35 patients who underwent 18FDG-PET/CT was evaluated in a secondary analysis. Results: HU values were significantly different between NENs and HAs in the PCp (P<0.001). NCp and Dp attenuation values did not show significant differences in the 2 groups. Differences in values of HUs in PCp and Dp allowed to discriminate between NENs and HAs. Conclusion: Wash-out analysis, ΔHU (PCp-Dp), can perfectly discriminate pulmonary “fat-poor” HAs from NENs.

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A CT-Based Radiomic Signature for the Differentiation of Pulmonary Hamartomas from Carcinoid Tumors

Cited by 10 publications

References 30 publications

Differentiating Peripherally Located Pulmonary Noncalcified Hamartoma From Carcinoid Using CT Radiomics Approaches

Differentiating Peripherally Located Pulmonary Noncalcified Hamartoma From Carcinoid Using CT Radiomics Approaches

The clinicopathological challenges of symptomatic and incidental pulmonary hamartomas diagnosis

Washout-Computed Tomography Discriminates Pulmonary “Fat-poor” Hamartomas From Neuroendocrine Neoplasms

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