Improved differentiation between primary lung cancer and pulmonary metastasis by combining dual-energy CT–derived biomarkers with conventional CT attenuation
Why this work is in the frame
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Bibliographic record
Abstract
Abstract Objectives To assess the clinical utility of dual-energy CT (DE-CT)–derived iodine concentration (IC) and effective Z (Z eff ) in addition to conventional CT attenuation (HU) for the discrimination between primary lung cancer (LC) and pulmonary metastases (PM) from different primary malignancies. Methods DE-CT scans of 79 patients with LC (3 histopathologic subgroups) and 89 patients with PM (5 histopathologic subgroups) were evaluated. Quantitative IC, Z eff , and conventional HU values were extracted and normalized to the thoracic aorta. Differences between groups were assessed by pairwise Welch’s t test. Correlation and linear regression analyses were used to examine the relationship of imaging parameters in LC and PM. Diagnostic accuracy was measured by the area under receiver operator characteristic curve (AUC) and validated based on resampling methods. Results Significant differences between subgroups of LC and PMs were noted for all imaging parameters, with the highest number of significant pairs for IC. In univariate analysis, only IC was a significant diagnostic feature for discriminating LC from PM ( p = 0.03). All quantitative imaging parameters correlated significantly ( p < 0.0001, respectively), with the highest correlation between IC and Z eff ( r = 0.91), followed by IC and HU ( r = 0.76) and Z eff and HU ( r = 0.73). Diagnostic models combining IC or Z eff with HU (IC+HU: AUC = 0.73; Z eff +HU: AUC = 0.69; IC+Z eff +HU: AUC = 0.73) were not significantly different and outperformed individual parameters (IC: AUC = 0.57; Z eff : AUC = 0.57; HU: AUC = 0.55) in diagnostic accuracy ( p < 0.05, respectively). Conclusion DE-CT-derived IC or Z eff and conventional HU represent complementary imaging parameters, which, if used in combination, may improve the differentiation between LC and PM. Key Points • Individual quantitative imaging parameters derived from DE-CT (iodine concentration, effective Z) and conventional CT (HU) provide complementary diagnostic information for the differentiation of primary lung cancer and pulmonary metastases. • A combination of conventional HU and DE-CT parameters enhances the diagnostic utility of individual parameters.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it