Prediction of malignant lymph nodes in NSCLC by machine-learning classifiers using EBUS-TBNA and PET/CT

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Maja Guberina - , University of Duisburg-Essen (Author)
  • Ken Herrmann - , University of Duisburg-Essen (Author)
  • Christoph Pöttgen - , University of Duisburg-Essen (Author)
  • Nika Guberina - , University of Duisburg-Essen (Author)
  • Hubertus Hautzel - , University of Duisburg-Essen (Author)
  • Thomas Gauler - , University of Duisburg-Essen (Author)
  • Till Ploenes - , University of Duisburg-Essen (Author)
  • Lale Umutlu - , University of Duisburg-Essen (Author)
  • Axel Wetter - , University of Duisburg-Essen (Author)
  • Dirk Theegarten - , University of Duisburg-Essen (Author)
  • Clemens Aigner - , University of Duisburg-Essen (Author)
  • Wilfried E.E. Eberhardt - , University of Duisburg-Essen (Author)
  • Martin Metzenmacher - , University of Duisburg-Essen (Author)
  • Marcel Wiesweg - , University of Duisburg-Essen (Author)
  • Martin Schuler - , University of Duisburg-Essen (Author)
  • Rüdiger Karpf-Wissel - , University of Duisburg-Essen (Author)
  • Alina Santiago Garcia - , University of Duisburg-Essen (Author)
  • Kaid Darwiche - , University of Duisburg-Essen (Author)
  • Martin Stuschke - , University of Duisburg-Essen (Author)

Abstract

Accurate determination of lymph-node (LN) metastases is a prerequisite for high precision radiotherapy. The primary aim is to characterise the performance of PET/CT-based machine-learning classifiers to predict LN-involvement by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in stage-III NSCLC. Prediction models for LN-positivity based on [18F]FDG-PET/CT features were built using logistic regression and machine-learning models random forest (RF) and multilayer perceptron neural network (MLP) for stage-III NSCLC before radiochemotherapy. A total of 675 LN-stations were sampled in 180 patients. The logistic and RF models identified SUVmax, the short-axis LN-diameter and the echelon of the considered LN among the most important parameters for EBUS-positivity. Adjusting the sensitivity of machine-learning classifiers to that of the expert-rater of 94.5%, MLP (P = 0.0061) and RF models (P = 0.038) showed lower misclassification rates (MCR) than the standard-report, weighting false positives and false negatives equally. Increasing the sensitivity of classifiers from 94.5 to 99.3% resulted in increase of MCR from 13.3/14.5 to 29.8/34.2% for MLP/RF, respectively. PET/CT-based machine-learning classifiers can achieve a high sensitivity (94.5%) to detect EBUS-positive LNs at a low misclassification rate. As the specificity decreases rapidly above that level, a combined test of a PET/CT-based MLP/RF classifier and EBUS-TBNA is recommended for radiation target volume definition.

Details

Original languageEnglish
Article number17511
Number of pages13
JournalScientific reports
Volume12
Publication statusPublished - 20 Oct 2022
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 36266403