Lee Kyung Won, Kim Miyoung, Gierada David S, Bae Kyongtae T
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
AJR Am J Roentgenol. 2007 Nov;189(5):1077-81. doi: 10.2214/AJR.07.2057.
The purpose of this study was to evaluate the performance of a computer-aided program that allows automated matching of metastatic pulmonary nodules imaged with two serial clinical chest CT studies.
The cases of 30 patients with metastatic pulmonary nodules depicted on two serial clinical MDCT scans (16- or 64-MDCT, 5-mm section thickness) were studied. The number of nodules per patient varied from a minimum of two to innumerable. A maximum of 10 well-defined solid nodules per patient, a total of 210 nodules, were selected from each baseline CT scan and were evaluated for matching detection in follow-up CT by means of an automated program. Substantial changes in lung findings and lung volumes between serial scans were visually assessed. The effects on matching rate of interval lung changes and location, size, and total number of nodules in the lung were analyzed with contingency tables. Chi-square tests were used to evaluate patterns for statistical significance.
The nodule-matching rate per patient ranged from 0 to 100% (median, 87.5%). By nodule, the overall matching rate was 140 of 210 (66.7%). Matching rate was highly associated with changes in lung quality between serial studies. Matching of 122 of 148 nodules (82.4%) occurred in 23 patients with relatively unchanged lung findings, compared with 18 of 62 nodules (29.0%) in seven patients with substantial interval changes (p < 0.001). The matching rate decreased with an increased total number of nodules per lung. For 10 or fewer nodules per lung, matching was successful for 31 of 36 nodules; for 11-50 nodules per lung, 60 of 73 nodules; for 51-100 nodules per lung, 33 of 47 nodules; and for more than 100 nodules per lung, 16 of 54 nodules (p < 0.001). The matching rate was not significantly different with location or size of nodules.
The rate of automated matching of metastatic pulmonary nodules on clinical serial CT scans was high (82.4%) when the lung findings and lung expansion between the serial scans were relatively unchanged. The rate decreased significantly, however, with substantial interval changes in the lung and a larger number of nodules.
本研究旨在评估一种计算机辅助程序的性能，该程序可对两次连续临床胸部CT检查成像的转移性肺结节进行自动匹配。
研究了30例在两次连续临床MDCT扫描（16层或64层MDCT，层厚5mm）上显示有转移性肺结节的患者病例。每位患者的结节数量从最少2个到无数个不等。从每次基线CT扫描中，每位患者最多选取10个边界清晰的实性结节，共210个结节，并通过自动程序评估其在随访CT中的匹配检测情况。对连续扫描之间肺部表现和肺容积的显著变化进行视觉评估。使用列联表分析肺部间隔变化以及肺内结节的位置、大小和总数对匹配率的影响。采用卡方检验评估模式的统计学意义。
每位患者的结节匹配率在0%至100%之间（中位数为87.5%）。按结节计算，总体匹配率为210个结节中的140个（66.7%）。匹配率与连续研究之间肺部质量的变化高度相关。在肺部表现相对无变化的23例患者中，148个结节中的122个（82.4%）实现了匹配，而在肺部有显著间隔变化的7例患者中，62个结节中的18个（29.0%）实现了匹配（p<0.001）。匹配率随每侧肺内结节总数的增加而降低。每侧肺内结节数为10个或更少时，36个结节中的31个匹配成功；每侧肺内结节数为11 - 50个时，73个结节中的60个匹配成功；每侧肺内结节数为51 - 100个时，47个结节中的33个匹配成功；每侧肺内结节数超过100个时，54个结节中的16个匹配成功（p<0.001）。匹配率在结节的位置或大小方面无显著差异。
当连续扫描之间肺部表现和肺扩张相对无变化时，临床连续CT扫描上转移性肺结节的自动匹配率较高（82.4%）。然而，随着肺部出现显著间隔变化以及结节数量增多，匹配率会显著降低。
