Computer-aided interpretation of chest radiography reveals the spectrum of tuberculosis in rural South Africa.
Computer-aided interpretation of chest radiography reveals the spectrum of tuberculosis in rural South Africa.
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DOI：
10.1038/s41746-021-00471-y
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发表时间：
2021-07-02
影响因子：
15.2
通讯作者：
Vukuzazi Team
中科院分区：
文献类型：
--
作者：
Fehr J;Konigorski S;Olivier S;Gunda R;Surujdeen A;Gareta D;Smit T;Baisley K;Moodley S;Moosa Y;Hanekom W;Koole O;Ndung'u T;Pillay D;Grant AD;Siedner MJ;Lippert C;Wong EB;Vukuzazi Team
计算机辅助数字化胸片判读（CAD）可以促进结核病（TB）的高通量筛查，但其在基于人群的主动病例发现计划中的应用有限。在南非农村的艾滋病流行地区，我们使用CAD算法（CAD4TBv5）来解释数字胸部X射线（CXR）作为移动的健康筛查工作的一部分。TB症状或CAD4TBv5评分高于分诊阈值的参与者被转诊进行微生物痰液评估。在最初的试点阶段，选择了25的低CAD4TBv5分类阈值，以最大限度地发现TB病例。我们报告了CAD4TBv5在筛选9，914名参与者中的表现，其中99名（1.0%）被发现患有微生物学证实的TB。CAD4TBv5能够以与设盲放射科医师相同的灵敏度但较低的特异性识别TB病例，而下一代算法（CAD4TBv6）实现了与放射科医师相当的灵敏度和特异性。微生物学确诊的结核病患者的CXR涵盖了一系列肺野异常，包括19例（19.2%）放射科医生认为正常的病例。HIV血清状态不影响CAD4TB的性能。值得注意的是，在这项基于人群的调查中发现的结核病例中，78.8%无症状，因此仅根据CAD4TBv5评分进行痰液采集分流。虽然CAD4TBv6有可能取代放射科医生在结核病患病率调查中对CXR进行分诊，但有必要进行特定人群的试点，以设定适当的分诊阈值。需要进一步研究图像分析策略，以识别放射学上不明显的活动性结核病。
Computer-aided digital chest radiograph interpretation (CAD) can facilitate high-throughput screening for tuberculosis (TB), but its use in population-based active case-finding programs has been limited. In an HIV-endemic area in rural South Africa, we used a CAD algorithm (CAD4TBv5) to interpret digital chest x-rays (CXR) as part of a mobile health screening effort. Participants with TB symptoms or CAD4TBv5 score above the triaging threshold were referred for microbiological sputum assessment. During an initial pilot phase, a low CAD4TBv5 triaging threshold of 25 was selected to maximize TB case finding. We report the performance of CAD4TBv5 in screening 9,914 participants, 99 (1.0%) of whom were found to have microbiologically proven TB. CAD4TBv5 was able to identify TB cases at the same sensitivity but lower specificity as a blinded radiologist, whereas the next generation of the algorithm (CAD4TBv6) achieved comparable sensitivity and specificity to the radiologist. The CXRs of people with microbiologically confirmed TB spanned a range of lung field abnormality, including 19 (19.2%) cases deemed normal by the radiologist. HIV serostatus did not impact CAD4TB’s performance. Notably, 78.8% of the TB cases identified during this population-based survey were asymptomatic and therefore triaged for sputum collection on the basis of CAD4TBv5 score alone. While CAD4TBv6 has the potential to replace radiologists for triaging CXRs in TB prevalence surveys, population-specific piloting is necessary to set the appropriate triaging thresholds. Further work on image analysis strategies is needed to identify radiologically subtle active TB.
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DOI：
10.5588/ijtld.17.0827
发表时间：
2018-09-01
影响因子：
4
作者：
Koesoemadinata, R. C.;Kranzer, K.;Hill, P. C.
通讯作者：
Hill, P. C.
影响因子：
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作者：
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通讯作者：
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DOI：
10.1136/bmj.h5527
发表时间：
2015-10-28
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
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STARD Group
新的XPERT MTB/RIF ULTRA：改善了结核分枝杆菌的检测和对利福平的耐药性，适用于适合护理点测试的测定。
影响因子：
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作者：
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通讯作者：
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影响因子：
168.9
作者：
Corbett, Elizabeth L.;Bandason, Tsitsi;Duong, Trinh;Dauya, Ethel;Makamure, Beauty;Churchyard, Gavin J.;Williams, Brian G.;Munyati, Shungu S.;Butterworth, Anthony E.;Mason, Peter R.;Mungofa, Stanley;Hayes, Richard J.
通讯作者：
Hayes, Richard J.