1.Deep Learning-Based Computer-Aided Diagnosis in Coronary Artery Calcium-Scoring CT for Pulmonary Nodule Detection: A Preliminary Study
Seung Yun LEE ; Ji Weon LEE ; Jung Im JUNG ; Kyunghwa HAN ; Suyon CHANG
Yonsei Medical Journal 2025;66(4):240-248
Purpose:
To evaluate the feasibility and utility of deep learning-based computer-aided diagnosis (DL-CAD) for the detection of pulmonary nodules on coronary artery calcium (CAC)-scoring computed tomography (CT).
Materials and Methods:
This retrospective study included 273 patients (aged 63.9±13.2 years; 129 men) who underwent CACscoring CT. A DL-CAD system based on thin-section images was used for pulmonary nodule detection, and two independent junior readers reviewed the standard CAC-scoring CT scans with and without referencing DL-CAD results. A reference standard was established through the consensus of two experienced radiologists. Sensitivity, positive predictive value, and F1-score were assessed on a per-nodule and per-patient basis. The patients’ medical records were monitored until November 2023.
Results:
A total of 269 nodules were identified in 129 patients. With DL-CAD assistance, the readers’ sensitivity significantly improved (65% vs. 80% for reader 1; 82% vs. 86% for reader 2; all p<0.001), without a notable increase in the number of false-positives per case (0.11 vs. 0.13, p=0.078 for reader 1; 0.11 vs. 0.11, p>0.999 for reader 2). Per-patient analysis also enhanced sensitivity with DL-CAD assistance (73% vs. 84%, p<0.001 for reader 1; 89% vs. 91%, p=0.250 for reader 2). During follow-up, lung cancer was diagnosed in four patients (1.5%). Among them, two had lesions detected on CAC-scoring CT, both of which were successfully identified by DL-CAD.
Conclusion
DL-CAD based on thin-section images can assist less experienced readers in detecting pulmonary nodules on CACscoring CT scans, improving detection sensitivity without significantly increasing false-positives.
2.Deep Learning-Based Computer-Aided Diagnosis in Coronary Artery Calcium-Scoring CT for Pulmonary Nodule Detection: A Preliminary Study
Seung Yun LEE ; Ji Weon LEE ; Jung Im JUNG ; Kyunghwa HAN ; Suyon CHANG
Yonsei Medical Journal 2025;66(4):240-248
Purpose:
To evaluate the feasibility and utility of deep learning-based computer-aided diagnosis (DL-CAD) for the detection of pulmonary nodules on coronary artery calcium (CAC)-scoring computed tomography (CT).
Materials and Methods:
This retrospective study included 273 patients (aged 63.9±13.2 years; 129 men) who underwent CACscoring CT. A DL-CAD system based on thin-section images was used for pulmonary nodule detection, and two independent junior readers reviewed the standard CAC-scoring CT scans with and without referencing DL-CAD results. A reference standard was established through the consensus of two experienced radiologists. Sensitivity, positive predictive value, and F1-score were assessed on a per-nodule and per-patient basis. The patients’ medical records were monitored until November 2023.
Results:
A total of 269 nodules were identified in 129 patients. With DL-CAD assistance, the readers’ sensitivity significantly improved (65% vs. 80% for reader 1; 82% vs. 86% for reader 2; all p<0.001), without a notable increase in the number of false-positives per case (0.11 vs. 0.13, p=0.078 for reader 1; 0.11 vs. 0.11, p>0.999 for reader 2). Per-patient analysis also enhanced sensitivity with DL-CAD assistance (73% vs. 84%, p<0.001 for reader 1; 89% vs. 91%, p=0.250 for reader 2). During follow-up, lung cancer was diagnosed in four patients (1.5%). Among them, two had lesions detected on CAC-scoring CT, both of which were successfully identified by DL-CAD.
Conclusion
DL-CAD based on thin-section images can assist less experienced readers in detecting pulmonary nodules on CACscoring CT scans, improving detection sensitivity without significantly increasing false-positives.
3.Deep Learning-Based Computer-Aided Diagnosis in Coronary Artery Calcium-Scoring CT for Pulmonary Nodule Detection: A Preliminary Study
Seung Yun LEE ; Ji Weon LEE ; Jung Im JUNG ; Kyunghwa HAN ; Suyon CHANG
Yonsei Medical Journal 2025;66(4):240-248
Purpose:
To evaluate the feasibility and utility of deep learning-based computer-aided diagnosis (DL-CAD) for the detection of pulmonary nodules on coronary artery calcium (CAC)-scoring computed tomography (CT).
Materials and Methods:
This retrospective study included 273 patients (aged 63.9±13.2 years; 129 men) who underwent CACscoring CT. A DL-CAD system based on thin-section images was used for pulmonary nodule detection, and two independent junior readers reviewed the standard CAC-scoring CT scans with and without referencing DL-CAD results. A reference standard was established through the consensus of two experienced radiologists. Sensitivity, positive predictive value, and F1-score were assessed on a per-nodule and per-patient basis. The patients’ medical records were monitored until November 2023.
Results:
A total of 269 nodules were identified in 129 patients. With DL-CAD assistance, the readers’ sensitivity significantly improved (65% vs. 80% for reader 1; 82% vs. 86% for reader 2; all p<0.001), without a notable increase in the number of false-positives per case (0.11 vs. 0.13, p=0.078 for reader 1; 0.11 vs. 0.11, p>0.999 for reader 2). Per-patient analysis also enhanced sensitivity with DL-CAD assistance (73% vs. 84%, p<0.001 for reader 1; 89% vs. 91%, p=0.250 for reader 2). During follow-up, lung cancer was diagnosed in four patients (1.5%). Among them, two had lesions detected on CAC-scoring CT, both of which were successfully identified by DL-CAD.
Conclusion
DL-CAD based on thin-section images can assist less experienced readers in detecting pulmonary nodules on CACscoring CT scans, improving detection sensitivity without significantly increasing false-positives.
4.Deep Learning-Based Computer-Aided Diagnosis in Coronary Artery Calcium-Scoring CT for Pulmonary Nodule Detection: A Preliminary Study
Seung Yun LEE ; Ji Weon LEE ; Jung Im JUNG ; Kyunghwa HAN ; Suyon CHANG
Yonsei Medical Journal 2025;66(4):240-248
Purpose:
To evaluate the feasibility and utility of deep learning-based computer-aided diagnosis (DL-CAD) for the detection of pulmonary nodules on coronary artery calcium (CAC)-scoring computed tomography (CT).
Materials and Methods:
This retrospective study included 273 patients (aged 63.9±13.2 years; 129 men) who underwent CACscoring CT. A DL-CAD system based on thin-section images was used for pulmonary nodule detection, and two independent junior readers reviewed the standard CAC-scoring CT scans with and without referencing DL-CAD results. A reference standard was established through the consensus of two experienced radiologists. Sensitivity, positive predictive value, and F1-score were assessed on a per-nodule and per-patient basis. The patients’ medical records were monitored until November 2023.
Results:
A total of 269 nodules were identified in 129 patients. With DL-CAD assistance, the readers’ sensitivity significantly improved (65% vs. 80% for reader 1; 82% vs. 86% for reader 2; all p<0.001), without a notable increase in the number of false-positives per case (0.11 vs. 0.13, p=0.078 for reader 1; 0.11 vs. 0.11, p>0.999 for reader 2). Per-patient analysis also enhanced sensitivity with DL-CAD assistance (73% vs. 84%, p<0.001 for reader 1; 89% vs. 91%, p=0.250 for reader 2). During follow-up, lung cancer was diagnosed in four patients (1.5%). Among them, two had lesions detected on CAC-scoring CT, both of which were successfully identified by DL-CAD.
Conclusion
DL-CAD based on thin-section images can assist less experienced readers in detecting pulmonary nodules on CACscoring CT scans, improving detection sensitivity without significantly increasing false-positives.
5.Deep Learning-Based Computer-Aided Diagnosis in Coronary Artery Calcium-Scoring CT for Pulmonary Nodule Detection: A Preliminary Study
Seung Yun LEE ; Ji Weon LEE ; Jung Im JUNG ; Kyunghwa HAN ; Suyon CHANG
Yonsei Medical Journal 2025;66(4):240-248
Purpose:
To evaluate the feasibility and utility of deep learning-based computer-aided diagnosis (DL-CAD) for the detection of pulmonary nodules on coronary artery calcium (CAC)-scoring computed tomography (CT).
Materials and Methods:
This retrospective study included 273 patients (aged 63.9±13.2 years; 129 men) who underwent CACscoring CT. A DL-CAD system based on thin-section images was used for pulmonary nodule detection, and two independent junior readers reviewed the standard CAC-scoring CT scans with and without referencing DL-CAD results. A reference standard was established through the consensus of two experienced radiologists. Sensitivity, positive predictive value, and F1-score were assessed on a per-nodule and per-patient basis. The patients’ medical records were monitored until November 2023.
Results:
A total of 269 nodules were identified in 129 patients. With DL-CAD assistance, the readers’ sensitivity significantly improved (65% vs. 80% for reader 1; 82% vs. 86% for reader 2; all p<0.001), without a notable increase in the number of false-positives per case (0.11 vs. 0.13, p=0.078 for reader 1; 0.11 vs. 0.11, p>0.999 for reader 2). Per-patient analysis also enhanced sensitivity with DL-CAD assistance (73% vs. 84%, p<0.001 for reader 1; 89% vs. 91%, p=0.250 for reader 2). During follow-up, lung cancer was diagnosed in four patients (1.5%). Among them, two had lesions detected on CAC-scoring CT, both of which were successfully identified by DL-CAD.
Conclusion
DL-CAD based on thin-section images can assist less experienced readers in detecting pulmonary nodules on CACscoring CT scans, improving detection sensitivity without significantly increasing false-positives.
9.Diagnostic Efficacy and Safety of Low-Contrast-Dose Dual-Energy CT in Patients With Renal Impairment Undergoing Transcatheter Aortic Valve Replacement
Suyon CHANG ; Jung Im JUNG ; Kyongmin Sarah BECK ; Kiyuk CHANG ; Yaeni KIM ; Kyunghwa HAN
Korean Journal of Radiology 2024;25(7):634-643
Objective:
This study aimed to evaluate the diagnostic efficacy and safety of low-contrast-dose, dual-source dual-energy CT before transcatheter aortic valve replacement (TAVR) in patients with compromised renal function.
Materials and Methods:
A total of 54 consecutive patients (female:male, 26:38; 81.9 ± 7.3 years) with reduced renal function underwent pre-TAVR dual-energy CT with a 30-mL contrast agent between June 2022 and March 2023. Monochromatic (40- and 50-keV) and conventional (120-kVp) images were reconstructed and analyzed. The subjective quality score, vascular attenuation, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) were compared among the imaging techniques using the Friedman test and post-hoc analysis. Interobserver reliability for aortic annular measurement was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. The procedural outcomes and incidence of post-contrast acute kidney injury (AKI) were assessed.
Results:
Monochromatic images achieved diagnostic quality in all patients. The 50-keV images achieved superior vascular attenuation and CNR (P < 0.001 in all) while maintaining a similar SNR compared to conventional CT. For aortic annular measurement, the 50-keV images showed higher interobserver reliability compared to conventional CT: ICC, 0.98 vs. 0.90 for area and 0.97 vs. 0.95 for perimeter; 95% limits of agreement width, 0.63 cm2 vs. 0.92 cm2 for area and 5.78 mm vs. 8.50 mm for perimeter. The size of the implanted device matched CT-measured values in all patients, achieving a procedural success rate of 92.6%. No patient experienced a serum creatinine increase of ≥ 1.5 times baseline in the 48–72 hours following CT. However, one patient had a procedural delay due to gradual renal function deterioration.
Conclusion
Low-contrast-dose imaging with 50-keV reconstruction enables precise pre-TAVR evaluation with improved image quality and minimal risk of post-contrast AKI. This approach may be an effective and safe option for pre-TAVR evaluation in patients with compromised renal function.
10.Migratory Pneumonia in Prolonged SARS-CoV-2 Infection in Patients Treated With B-cell Depletion Therapies for B-cell Lymphoma
Jongmin LEE ; Raeseok LEE ; Kyongmin Sarah BECK ; Dae Hee HAN ; Gi June MIN ; Suyon CHANG ; Jung Im JUNG ; Dong-Gun LEE
Korean Journal of Radiology 2023;24(4):362-370
Objective:
To report the clinical and radiological characteristics of patients with underlying B-cell lymphoma and coronavirus disease 2019 (COVID-19) showing migratory airspace opacities on serial chest computed tomography (CT) with persistent COVID-19 symptoms.
Materials and Methods:
From January 2020 to June 2022, of the 56 patients with underlying hematologic malignancy who had undergone chest CT more than once at our hospital after acquiring COVID-19, seven adult patients (5 female; age range, 37–71 years; median age, 45 years) who showed migratory airspace opacities on chest CT were selected for the analysis of clinical and CT features.
Results:
All patients had been diagnosed with B-cell lymphoma (three diffuse large B-cell lymphoma and four follicular lymphoma) and had received B-cell depleting chemotherapy, including rituximab, within three months prior to COVID-19 diagnosis. The patients underwent a median of 3 CT scans during the follow-up period (median 124 days). All patients showed multifocal patchy peripheral ground glass opacities (GGOs) with basal predominance in the baseline CTs. In all patients, followup CTs demonstrated clearing of previous airspace opacities with the development of new peripheral and peribronchial GGO and consolidation in different locations. Throughout the follow-up period, all patients demonstrated prolonged COVID-19 symptoms accompanied by positive polymerase chain reaction results from nasopharyngeal swabs, with cycle threshold values of less than 25.
Conclusion
COVID-19 patients with B-cell lymphoma who had received B-cell depleting therapy and are experiencing prolonged SARS-CoV-2 infection and persistent symptoms may demonstrate migratory airspace opacities on serial CT, which could be interpreted as ongoing COVID-19 pneumonia.

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