SY-002Sybil responds more weakly to nodules near the pleura, where adenocarcinoma tends to appear
Bartlomiej Sobieski, Jakub Grzywaczewski, Karol Dobiczek, Mateusz Wójcik, Tomasz Bartczak, Patryk Szatkowski, Przemysław Bombiński, Matthew Tivnan, Przemyslaw Biecek
The authors inserted 10 malignant and 10 benign nodules into 12 target scans, using a diffusion-bridge procedure to integrate each nodule with the surrounding anatomy. Across 240 patient-nodule combinations and approximately 900 lung positions per combination, Sybil responded more strongly in the upper lobes but less strongly near the pleural surface. The latter is clinically concerning because adenocarcinoma predominantly arises in the lung periphery.
Evidence
interventional
Key metric
about 200,000 insertions; upper versus middle and lower lobes p <= 0.009; distance to pleura p < 0.001
Caveat
Distance to the pleura alone explained little attribution variance (R2 = 0.071); adding interactions with nodule identity raised R2 to 0.455. Zero-padding is proposed only as a hypothesis for the radial bias. The interventions are partially synthetic, which the authors identify as the study's primary limitation, although insertion realism was assessed by two board-certified radiologists.