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Endobronchial ultrasound (EBUS) multimodal image including grey scale, blood flow doppler and elastography, can be used as non-invasive diagnosis and supplement the pathological result, which has important clinical application value. In this study, EBUS multimodal image database of 1000 inthoracic benign and malignant lymph nodes (LNs) will be constructed to train deep learning neural networks, which can automatically select representative images and diagnose LNs. Investigators will establish an artificial intelligence prediction model based on deep learning of intrathoracic LNs, and verify the model in other 300 LNs.
Intrathoracic LNs enlargement has a wide range of diseases, among which intrathoracic LNs metastasis of lung cancer is the most common malignant disease. Benign lesions, including inflammation, tuberculosis and sarcoidosis, also need to be differentiated for targeted treatment.
EBUS multimodal image including grey scale, blood flow doppler and elastography, can be used as non-invasive diagnosis and supplement the pathological result, which has important clinical application value. This study includes two parts: retrospectively construction of EBUS artificial intelligence prediction model and multi-center prospectively validation of the prediction model. A total of 1300 LNs will be enrolled in the study.
During the retention of videos, target LNs and peripheral vessels are examined using ultrasound hosts (EU-ME2, Olympus or Hi-vision Avius, Hitachi) equipped with elastography and doppler functions and ultrasound bronchoscopy (BF-UC260FW, Olympus or EB1970UK, Pentax). Multimodal image data of target LNs are collected.
Investigators will construct artificial intelligence prediction model based on deep learning using images from 1000 LNs firstly, and verify the model in other 300 LNs. This model will be compared with traditional qualitative and quantitative evaluation methods to verify the diagnostic efficacy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Prospectively validation group | Two diagnosis methods will be used in the prospective validation section, one is traditional qualitative and quantitative method, the other is artificial intelligence prediction model based on videos to compare the diagnostic efficacy. |
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| Measure | Description | Time Frame |
|---|---|---|
| Diagnostic efficacy of EBUS multimodal artificial intelligence prediction model based on videos | Diagnostic efficacy includes sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. | 6 months post-procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Diagnostic efficacy of traditional qualitative and quantitative methods | Diagnostic efficacy includes sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. | 6 months post-procedure |
| Diagnostic efficacy of multimodal deep learning model based on images |
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Inclusion Criteria:
Exclusion Criteria:
- Patients having other situations that are not suitable for EBUS-TBNA.
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Patients with enlarged intrathoracic LNs that need to be diagnosed by EBUS-TBNA are enrolled in this study.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jiayuan Sun, MD, PhD | Contact | 86-21-22200000 | 1511 | jysun1976@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Jiayuan Sun, MD, PhD | Shanghai Chest Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shanghai Chest Hospital | Recruiting | Shanghai | Shanghai Municipality | 200030 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20521347 | Background | Steinfort DP, Conron M, Tsui A, Pasricha SR, Renwick WE, Antippa P, Irving LB. Endobronchial ultrasound-guided transbronchial needle aspiration for the evaluation of suspected lymphoma. J Thorac Oncol. 2010 Jun;5(6):804-9. doi: 10.1097/jto.0b013e3181d873be. | |
| 24035300 | Background | Sun J, Teng J, Yang H, Li Z, Zhang J, Zhao H, Garfield DH, Han B. Endobronchial ultrasound-guided transbronchial needle aspiration in diagnosing intrathoracic tuberculosis. Ann Thorac Surg. 2013 Dec;96(6):2021-7. doi: 10.1016/j.athoracsur.2013.07.005. Epub 2013 Sep 12. |
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Investigators may release the database after the study, but no decision has been made yet.
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Diagnostic efficacy includes sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. |
| 6 months post-procedure |
| Comparion of prediction model based on deeping learning with traditional qualitative and quantitative methods | Diagnostic efficacy includes sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. | 6 months post-procedure |
| 20382710 | Background | Fujiwara T, Yasufuku K, Nakajima T, Chiyo M, Yoshida S, Suzuki M, Shibuya K, Hiroshima K, Nakatani Y, Yoshino I. The utility of sonographic features during endobronchial ultrasound-guided transbronchial needle aspiration for lymph node staging in patients with lung cancer: a standard endobronchial ultrasound image classification system. Chest. 2010 Sep;138(3):641-7. doi: 10.1378/chest.09-2006. Epub 2010 Apr 9. |
| 22525556 | Background | Nakajima T, Anayama T, Shingyoji M, Kimura H, Yoshino I, Yasufuku K. Vascular image patterns of lymph nodes for the prediction of metastatic disease during EBUS-TBNA for mediastinal staging of lung cancer. J Thorac Oncol. 2012 Jun;7(6):1009-14. doi: 10.1097/JTO.0b013e31824cbafa. |
| 26228606 | Background | Wang L, Wu W, Hu Y, Teng J, Zhong R, Han B, Sun J. Sonographic Features of Endobronchial Ultrasonography Predict Intrathoracic Lymph Node Metastasis in Lung Cancer Patients. Ann Thorac Surg. 2015 Oct;100(4):1203-9. doi: 10.1016/j.athoracsur.2015.04.143. Epub 2015 Jul 28. |
| 25121724 | Background | Izumo T, Sasada S, Chavez C, Matsumoto Y, Tsuchida T. Endobronchial ultrasound elastography in the diagnosis of mediastinal and hilar lymph nodes. Jpn J Clin Oncol. 2014 Oct;44(10):956-62. doi: 10.1093/jjco/hyu105. Epub 2014 Aug 13. |
| 21437851 | Background | Saftoiu A, Vilmann P, Gorunescu F, Janssen J, Hocke M, Larsen M, Iglesias-Garcia J, Arcidiacono P, Will U, Giovannini M, Dietrich C, Havre R, Gheorghe C, McKay C, Gheonea DI, Ciurea T; European EUS Elastography Multicentric Study Group. Accuracy of endoscopic ultrasound elastography used for differential diagnosis of focal pancreatic masses: a multicenter study. Endoscopy. 2011 Jul;43(7):596-603. doi: 10.1055/s-0030-1256314. Epub 2011 Mar 24. |
| 27898976 | Background | Gulshan V, Peng L, Coram M, Stumpe MC, Wu D, Narayanaswamy A, Venugopalan S, Widner K, Madams T, Cuadros J, Kim R, Raman R, Nelson PC, Mega JL, Webster DR. Development and Validation of a Deep Learning Algorithm for Detection of Diabetic Retinopathy in Retinal Fundus Photographs. JAMA. 2016 Dec 13;316(22):2402-2410. doi: 10.1001/jama.2016.17216. |