PMC8274706_01
16-Slice computed tomography scans during initial diagnosis. The axial planes (A), 3D view (B), coronal planes (C) showed a blocky mass in the left lung and uniform miliary nodules dispersed all lung lobes.
RMHP-14-2825-g0001.jpg
PMC8274706_01_RMHP-14-2825-g0001.jpg
f0001
A chest enhanced computed tomography (CT) scan revealed over 200 uniform size pulmonary nodules in an evenly dispersed pattern at bilateral lungs with a 38x45mm new creature at the dorsal segment of the lower lobe of the left lung (Figure 1A-C), in addition to a small amount of left-sided pleural and pericardial effusion.
Artificial intelligence (AI) system (the AI software supported by Hangzhou Yitu Medical Technology Limited Company) identified one high-risk nodules and 17 low-risk nodules.
RMHP-14-2825-g0002.jpg
PMC8274706_01_RMHP-14-2825-g0002.jpg
f0002
This module was developed as a combination of U-net and fully convolutional networks. Approaches for lung nodule segmentation involved the detection of a volume of interest (VOI) covering the nodule area and segmentation inside this VOI. These methods can be generally classified into machine-learning methods based on China big date, which covered more than 10 provinces and more than 50 hospitals), only identified 18 pulmonary nodules (Figure 2), which are lower than 10% of the real data.
Image of histologic diagnosis using hematoxylin and eosin staining (A) (original x100 magnification) from the enlarged left supraclavicular lymph nodes at the time of the initial diagnosis metastatic lung adenocarcinoma. Immunohistochemistry of TTF-1 (B), PCK (C), and Ki-67 (D) (original x100 magnification).
RMHP-14-2825-g0003.jpg
PMC8274706_01_RMHP-14-2825-g0003.jpg
f0003
TTF-1 (Figure 3B), PCK (Figure 3C), CK7, but negative for P40, Syn, and the Ki 67 index was reported in 70% (Figure 3D). The peripheral blood gene detection showed wild-type epidermal growth factor receptor (EGFR) with no gene mutation sites.
After combined therapy, the primary tumor size significantly decreased and the miliary lung metastasis almost wholly disappeared on 16-slice computed tomography.
RMHP-14-2825-g0004.jpg
PMC8274706_01_RMHP-14-2825-g0004.jpg
f0004
We recommended a combination therapy regimen, the subsequent imaging revealed a significant decrease in the size and number of primary tumors and metastases (Figure 4).