MSCT Follow-Up in Malignant Lymphoma: Comparison of Manual Linear Measurements with Semi-Automated Lymph Node Analysis for Therapy Response Classification

作者：Weissling J^*; Puesken M; Koch R; Kohlhase N; Persigehl T; Mesters R; Heindel W; Buerke B

来源：RoFo-Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren, 2012, 184(9): 795-804.

DOI：10.1055/s-0032-1312751

• lymphoma
• segmentation
• treatment effects
• CT
• lymphatic

Purpose: Assignment of semi-automated lymph node analysis compared to manual measurements for therapy response classification of malignant lymphoma in MSCT. %26lt;br%26gt;Materials and Methods: MSCT scans of 63 malignant lymphoma patients before and after 2 cycles of chemotherapy (307 target lymph nodes) were evaluated. The long axis diameter (LAD), short axis diameter (SAD) and bi-dimensional WHO were determined manually and semi-automatically. The time for manual and semi-automatic segmentation was evaluated. The ref. standard response was defined as the mean relative change across all manual and semi-automatic measurements (mean manual/semi-automatic LAD, SAD, semi-automatic volume). Statistical analysis encompassed t-test and McNemar%26apos;s test for clustered data. %26lt;br%26gt;Results: Response classification per lymph node revealed semi-automated volumetry and bi-dimensional WHO to be significantly more accurate than manual linear metric measurements. Response classification per patient based on RECIST revealed more patients to be correctly classified by semi-automatic measurements, e.g. 96.0%/92.9% (WHO bi-dimensional/volume) compared to 85.7/84.1% for manual LAD and SAD, respectively (mean reduction in misclassified patients of 9.95%). Considering the use of correction tools, the time expenditure for lymph node segmentation (29.7 +/- 17.4 sec) was the same as with the manual approach (29.1 +/- 14.5 sec). %26lt;br%26gt;Conclusion: Semi-automatically derived %26quot;lymph node volume%26quot; and %26quot;bi-dimensional WHO%26quot; significantly reduce the number of misclassified patients in the CT follow-up of malignant lymphoma by at least 10%. However, lymph node volumetry does not outperform bi-dimensional WHO.

• 出版日期2012-9