Paper
1 April 2024 Virtual NLST: towards replicating national lung screening trial
Author Affiliations +
Abstract
Virtual Imaging Trials, known as VITs, provide a computational substitute for clinical trials. These traditional trials tend to be sluggish, costly, and frequently deficient in definitive evidence, all the while subjecting participants to ionizing radiation. Our VIT platform meticulously mimics essential components of the imaging process, encompassing everything from virtual patients and scanners to simulated readers. Within the scope of this intended research, we aim to authenticate our virtual imaging trial platform by duplicating the results of the National Lung Screening Trial (NLST) for lung cancer screening through the emulation of low-dose computed tomography (CT) and chest radiography (CXR) procedures. The methodology involves creating 66 unique computational phantoms, each with inserted simulated lung nodules. Replicating NLST CT imaging via Duke Legacy W20 scanner matched essential properties. Virtual imaging was done through DukeSim. A LUNA16-trained virtual reader, combining a 3D RetinaNet model (front-end) with a ResNet-10 false positive reduction model (back-end), evaluated the virtually imaged data, ensuring rigorous assessment. The back-end model achieved a sensitivity of over 95% at fewer than 3 false positives per scan for both the clinical and virtual imaged CTs. Notably, nodule diameter-based analysis showcases even higher sensitivity for nodules measuring 10 mm or more. In conclusion, the integration of diverse computational and imaging techniques, culminating in a virtual reader, demonstrates promising sensitivity. To capture both arms of the trial, future research will compare virtual reader performance on CT with CXR. This affirms the transformative potential of virtual imaging trials in advancing evidence-based medicine, offering an efficient and ethically conscious approach to medical research and development.
(2024) Published by SPIE. Downloading of the abstract is permitted for personal use only.
Fakrul Islam Tushar, Liesbeth Vancoillie, Cindy McCabe, Amareswararao Kavuri, Lavsen Dahal, Brian Harrawood, Milo Fryling, Mojtaba Zarei, Saman Sotoudeh-Paima, Fong Chi Ho, Dhrubajyoti Ghosh, Sheng Luo, W. Paul Segars, Ehsan Abadi, Kyle J. Lafata, Ehsan Samei, and Joseph Y. Lo "Virtual NLST: towards replicating national lung screening trial", Proc. SPIE 12925, Medical Imaging 2024: Physics of Medical Imaging, 129252F (1 April 2024); https://doi.org/10.1117/12.3006915
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KEYWORDS
Data modeling

Lung

Computed tomography

Scanners

3D modeling

Computer simulations

Chest imaging

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