Publications by authors named "Bin-Jie Fu"

5 Publications

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Significance of intra-nodular vessel sign in differentiating benign and malignant pulmonary ground-glass nodules.

Insights Imaging 2021 May 26;12(1):65. Epub 2021 May 26.

Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, 1# Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China.

Background: The presence of pulmonary vessels inside ground-glass nodules (GGNs) of different nature is a very common occurrence. This study aimed to reveal the significance of pulmonary vessels displayed in GGNs in their diagnosis and differential diagnosis.

Results: A total of 149 malignant and 130 benign GGNs confirmed by postoperative pathological examination were retrospectively enrolled in this study. There were significant differences in size, shape, nodule-lung interface, pleural traction, lobulation, and spiculation (each p < 0.05) between benign and malignant GGNs. Compared with benign GGNs, intra-nodular vessels were more common in malignant GGNs (67.79% vs. 54.62%, p = 0.024), while the vascular categories were similar (p = 0.663). After adjusting the nodule size and the distance between the nodule center and adjacent pleura [radius-distance ratio, RDR], the occurrences of internal vessels between them were similar. The number of intra-nodular vessels was positively correlated with nodular diameter and RDR. Vascular changes were more common in malignant than benign GGNs (52.48% vs. 18.31%, p < 0.0001), which mainly manifested as distortion and/or dilation of pulmonary veins (61.19%). The occurrence rate, number, and changes of internal vessels had no significant differences among all the pre-invasive and invasive lesions (each p > 0.05).

Conclusions: The incidence of internal vessels in GGNs is mainly related to their size and the distance between nodule and pleura rather than the pathological nature. However, GGNs with dilated or distorted internal vessels, especially pulmonary veins, have a higher possibility of malignancy.
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http://dx.doi.org/10.1186/s13244-021-01012-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8155149PMC
May 2021

Completed absorption of coronavirus disease 2019 (COVID-19) pneumonia lesions: a preliminary study.

Int J Med Sci 2021 3;18(11):2321-2326. Epub 2021 Apr 3.

Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

Complete absorption of coronavirus disease 2019 (COVID-19) pneumonia in a short term was not detailedly reported. We aimed to investigate the clinical and imaging characteristics of COVID-19 patients with complete absorption of pulmonary lesions. Retrospectively collected the clinical and chest CT data of 224 patients with COVID-19 in one regional medical center. Currently, pulmonary lesions in 37 patients were completely absorbed. The clinical manifestations, laboratory examinations, and CT findings of lesions for these patients were summarized. Among the 37 patients (age, 39.0 ± 12.4 [14-63] years, 20 males), disease in 36 (97.3%) was mild and in 1 (2.7%) was from severe to mild. The most common symptoms were cough (24/37, 64.9%) and fever (23/37, 62.2%). Their laboratory indicators at admission were usually normal, while the white blood cell and neutrophil count significantly increased at discharge (p = 0.004, p = 0.006). On initial CT images, all patients had various pulmonary lesions (mean involved lobes: 2.8 ± 1.5, range: 1-5; mean involved segments: 6.6 ± 4.3, range: 1-16), which mainly manifested as multiple patchy and or spherical ground glass opacities (GGOs) (30/37, 81.1%) with fibrous strips (19/30, 63.3%) or consolidation (11/30, 36.7%). After treatment, lesions in most (33/37, 89.2%) patients were continuously absorbed. At discharge, previous lesions were mostly absorbed in 11 patients (11/37, 29.7%), the main residues were GGOs (24/37, 64.9%), followed by fibrous strips (13/37, 35.1%). On the latest CT, all the pulmonary lesions were completely absorbed, the duration of lesions was 31.6 ± 11.4 days (range: 5-50 days). The pulmonary lesions in some mild COVID-19 patients (generally with normal laboratory indicators at admission, GGOs as the main manifestation on initial CT, and representation of continuous absorption after treatment) could be completely absorbed with a mean duration of 31.6 days.
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http://dx.doi.org/10.7150/ijms.54675DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8100646PMC
May 2021

Pulmonary Benign Ground-Glass Nodules: CT Features and Pathological Findings.

Int J Gen Med 2021 24;14:581-590. Epub 2021 Feb 24.

Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.

Background: Some pulmonary ground-glass nodules (GGNs) are benign and frequently misdiagnosed due to lack of understanding of their CT characteristics. This study aimed to reveal the CT features and corresponding pathological findings of pulmonary benign GGNs to help improve diagnostic accuracy.

Patients And Methods: From March 2016 to October 2019, patients with benign GGNs confirmed by operation or follow-up were enrolled retrospectively. According to overall CT manifestations, GGNs were classified into three types: I, GGO with internal high-attenuation zone; II, nodules lying on adjacent blood vessels; and other type, lesions without obvious common characteristics. CT features and pathological findings of each nodule type were evaluated.

Results: Among the 40 type I, 25 type II, and 14 other type GGNs, 24 (60.0%), 19 (76.0%), and 10 (71.4%) nodules were resected, respectively. Type I GGNs were usually irregular (25 of 40, 62.5%) with only one high-attenuation zone (38 of 40, 95.0%) (main pathological components: thickened alveolar walls with inflammatory cells, fibrous tissue, and exudation), which was usually centric (24 of 40, 60.0%), having blurred margin (38 of 40, 95.0%), and connecting to blood vessels (32 of 40, 80.0%). The peripheral GGO (main pathological component: a small amount of inflammatory cell infiltration with fibrous tissue proliferation) was usually ill-defined (28 of 40, 70.0%). Type II GGNs (main pathological components: focal interstitial fibrosis with or without inflammatory cell infiltration) lying on adjacent vessel branches were usually irregular (19 of 25, 76.0%) and well defined (16 of 25, 64.0%) but showed coarse margins (15 of 16, 93.8%). Other type GGNs had various CT manifestations but their pathological findings were similar to that of type II.

Conclusion: For subsolid nodules with CT features manifested in type I or II GGNs, follow-up should be firstly considered in further management.
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http://dx.doi.org/10.2147/IJGM.S298517DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930605PMC
February 2021

Evaluate the performance of four artificial intelligence-aided diagnostic systems in identifying and measuring four types of pulmonary nodules.

J Appl Clin Med Phys 2021 Jan 24;22(1):318-326. Epub 2020 Dec 24.

School of Public Health and Management, Chongqing Medical University, Chongqing, China.

Purpose: This study aims to evaluate the performance of four artificial intelligence-aided diagnostic systems in identifying and measuring four types of pulmonary nodules.

Methods: Four types of nodules were implanted in a commercial lung phantom. The phantom was scanned with multislice spiral computed tomography, after which four systems (A, B, C, D) were used to identify the nodules and measure their volumes.

Results: The relative volume error (RVE) of system A was the lowest for all nodules, except for small ground glass nodules (SGGNs). System C had the smallest RVE for SGGNs, -0.13 (-0.56, 0.00). In the Bland-Altman test, only systems A and C passed the consistency test, P = 0.40. In terms of precision, the miss rate (MR) of system C was 0.00% for small solid nodules (SSNs), ground glass nodules (GGNs), and solid nodules (SNs) but 4.17% for SGGNs. The comparable system D MRs for SGGNs, SSNs, and GGNs were 71.30%, 25.93%, and 47.22%, respectively, the highest among all the systems. Receiver operating characteristic curve analysis indicated that system A had the best performance in recognizing SSNs and GGNs, with areas under the curve of 0.91 and 0.68. System C had the best performance for SGGNs (AUC = 0.91).

Conclusion: Among four types nodules, SGGNs are the most difficult to recognize, indicating the need to improve higher accuracy and precision of artificial systems. System A most accurately measured nodule volume. System C was most precise in recognizing all four types of nodules, especially SGGN.
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http://dx.doi.org/10.1002/acm2.13142DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856495PMC
January 2021

CT Characteristics for Predicting Invasiveness in Pulmonary Pure Ground-Glass Nodules.

AJR Am J Roentgenol 2020 08 29;215(2):351-358. Epub 2020 Apr 29.

Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Rd, Yuanjiagang, Yuzhong District, Chongqing 40016, China.

The objective of our study was to investigate the differences in the CT features of atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma (IA) manifesting as a pure ground-glass nodule (pGGN) with the aim of determining parameters predictive of invasiveness. A total of 161 patients with 172 pGGNs (14 AAHs, 59 AISs, 68 MIAs, and 31 IAs) were retrospectively enrolled. The following CT features of each histopathologic subtype of nodule were analyzed and compared: lesion location, diameter, area, shape, attenuation, uniformity of density, margin, nodule-lung interface, and internal and surrounding changes. ROC curves revealed that nodule diameter and area (cutoff value, 10.5 mm and 86.5 mm; sensitivity, 87.1% and 87.1%; specificity, 70.9% and 65.2%) were significantly larger in IAs than in AAHs, AISs, and MIAs ( < 0.001), whereas the latter three were similar in size ( > 0.050). CT attenuation higher than -632 HU in pGGNs indicated invasiveness (sensitivity, 78.8%; specificity, 59.8%). As opposed to noninvasive pGGNs (AAHs and AISs), invasive pGGNs (MIAs and IAs) usually had heterogeneous density, irregular shape, coarse margin, lobulation, spiculation, pleural indentation, and dilated or distorted vessels (each, < 0.050). Multivariate analysis showed that mean CT attenuation and presence of lobulation were predictors for invasive pGGNs ( ≤ 0.001). The likelihood of invasiveness is greater in pGGNs with larger size (> 10.5 mm or > 86.5 mm), higher attenuation (> -632 HU), heterogeneous density, irregular shape, coarse margin, spiculation, lobulation, pleural indentation, and dilated or distorted vessels.
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http://dx.doi.org/10.2214/AJR.19.22381DOI Listing
August 2020