title: Multicenter external validation of two malignancy risk prediction models in patients undergoing 18F-FDG-PET for solitary pulmonary nodule evaluation.
abstract: OBJECTIVE
  To achieve multicentre external validation of the Herder and Bayesian Inference Malignancy Calculator (BIMC) models.
  
  
  METHODS
  Two hundred and fifty-nine solitary pulmonary nodules (SPNs) collected from four major hospitals which underwent 18-FDG-PET characterization were included in this multicentre retrospective study. The Herder model was tested on all available lesions (group A). A subgroup of 180 SPNs (group B) was used to provide unbiased comparison between the Herder and BIMC models. Receiver operating characteristic (ROC) area under the curve (AUC) analysis was performed to assess diagnostic accuracy. Decision analysis was performed by adopting the risk threshold stated in British Thoracic Society (BTS) guidelines.
  
  
  RESULTS
  Unbiased comparison performed In Group B showed a ROC AUC for the Herder model of 0.807 (95 % CI 0.742-0.862) and for the BIMC model of 0.822 (95 % CI 0.758-0.875).
  
  
  CONCLUSIONS
  Both the Herder and the BIMC models were proven to accurately predict the risk of malignancy when tested on a large multicentre external case series. The BIMC model seems advantageous on the basis of a more favourable decision analysis.
  
  
  CONCLUSIONS
  • The Herder model showed a ROC AUC of 0.807 on 180 SPNs. • The BIMC model showed a ROC AUC of 0.822 on 180 SPNs. • Decision analysis is more favourable to the BIMC model.
authors.affiliation: UOC Radiologia, Ospedale Maggiore di Borgo Trento, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, Verona, 37124, Italy. mail@simoneperandini.com.
authors.forename: Simone
authors.initials: S
authors.lastname: Perandini
authors.affiliation: UOC Radiologia, Ospedale Maggiore di Borgo Trento, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, Verona, 37124, Italy.
authors.forename: G A
authors.initials: GA
authors.lastname: Soardi
authors.affiliation: Dipartimento di Scienze Radiologiche, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: A R
authors.initials: AR
authors.lastname: Larici
authors.affiliation: Dipartimento di Scienze Radiologiche, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Del Ciello
authors.affiliation: UO Chirurgia Toracica, Ospedale Humanitas Gavazzeni, Bergamo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rizzardi
authors.affiliation: UO Radiologia, Ospedale Humanitas Gavazzeni, Bergamo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Solazzo
authors.affiliation: UO Pneumologia, Ospedale dell'Angelo di Mestre, Venezia, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Mancino
authors.affiliation: UO Pneumologia, Ospedale dell'Angelo di Mestre, Venezia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Zeraj
authors.affiliation: UO Radiologia, Ospedale dell'Angelo di Mestre, Venezia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bernhart
authors.affiliation: UOC Radiologia, Ospedale Maggiore di Borgo Trento, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, Verona, 37124, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Signorini
authors.affiliation: UOC Radiologia, Ospedale Maggiore di Borgo Trento, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, Verona, 37124, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Motton
authors.affiliation: UOC Radiologia, Ospedale Maggiore di Borgo Trento, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, Verona, 37124, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Montemezzi
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001499:Bayes Theorem; D003661:Decision Support Techniques; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012306:Risk; D018570:Risk Assessment; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18 F-fluorodeoxyglucose positron emission tomography; Computed tomography; Decision analysis; Lung cancer; Solid pulmonary nodule