Department of Radiology, The University of Michigan, Ann Arbor Michigan 48109-5842, USA.
Med Phys. 2009 Nov;36(11):5052-63. doi: 10.1118/1.3238101.
The goal of this study was to develop an automated method to segment breast masses on dynamic contrast-enhanced (DCE) magnetic resonance (MR) scans and to evaluate its potential for estimating tumor volume on pre- and postchemotherapy images and tumor change in response to treatment. A radiologist experienced in interpreting breast MR scans defined a cuboid volume of interest (VOI) enclosing the mass in the MR volume at one time point within the sequence of DCE-MR scans. The corresponding VOIs over the entire time sequence were then automatically extracted. A new 3D VOI representing the local pharmacokinetic activities in the VOI was generated from the 4D VOI sequence by summarizing the temporal intensity enhancement curve of each voxel with its standard deviation. The method then used the fuzzy c-means (FCM) clustering algorithm followed by morphological filtering for initial mass segmentation. The initial segmentation was refined by the 3D level set (LS) method. The velocity field of the LS method was formulated in terms of the mean curvature which guaranteed the smoothness of the surface, the Sobel edge information which attracted the zero LS to the desired mass margin, and the FCM membership function which improved segmentation accuracy. The method was evaluated on 50 DCE-MR scans of 25 patients who underwent neoadjuvant chemotherapy. Each patient had pre- and postchemotherapy DCE-MR scans on a 1.5 T magnet. The in-plane pixel size ranged from 0.546 to 0.703 mm and the slice thickness ranged from 2.5 to 4.5 mm. The flip angle was 15 degrees, repetition time ranged from 5.98 to 6.7 ms, and echo time ranged from 1.2 to 1.3 ms. Computer segmentation was applied to the coronal T1-weighted images. For comparison, the same radiologist who marked the VOI also manually segmented the mass on each slice. The performance of the automated method was quantified using an overlap measure, defined as the ratio of the intersection of the computer and the manual segmentation volumes to the manual segmentation volume. Pre- and postchemotherapy masses had overlap measures of 0.81 +/- 0.13 (mean +/- s.d.) and 0.71 +/- 0.22, respectively. The percentage volume reduction (PVR) estimated by computer and the radiologist were 55.5 +/- 43.0% (mean +/- s.d.) and 57.8 +/- 51.3%, respectively. Paired Student's t test indicated that the difference between the mean PVRs estimated by computer and the radiologist did not reach statistical significance (p = 0.641). The automated mass segmentation method may have the potential to assist physicians in monitoring volume change in breast masses in response to treatment.
这项研究的目的是开发一种自动方法来分割动态对比增强(DCE)磁共振(MR)扫描中的乳腺肿块,并评估其在化疗前后图像上估计肿瘤体积和肿瘤对治疗反应的潜力。一位在解读乳腺 MR 扫描方面经验丰富的放射科医生在 DCE-MR 扫描序列中的一个时间点定义了一个包含肿块的长方体感兴趣区(VOI)。然后,自动提取整个时间序列的相应 VOI。通过总结每个体素的时间增强曲线及其标准差,从 4D VOI 序列中生成新的 3D VOI,代表 VOI 中的局部药代动力学活动。该方法随后使用模糊 c-均值(FCM)聚类算法和形态滤波进行初始肿块分割。初始分割通过 3D 水平集(LS)方法进行细化。LS 方法的速度场由平均曲率公式化,这保证了表面的平滑度,Sobel 边缘信息将零 LS 吸引到所需的肿块边界,以及 FCM 隶属函数提高了分割精度。该方法在 25 名接受新辅助化疗的患者的 50 次 DCE-MR 扫描中进行了评估。每位患者在 1.5 T 磁体上进行了化疗前后的 DCE-MR 扫描。平面像素大小范围为 0.546 至 0.703 毫米,切片厚度范围为 2.5 至 4.5 毫米。翻转角为 15 度,重复时间范围为 5.98 至 6.7 毫秒,回波时间范围为 1.2 至 1.3 毫秒。计算机分割应用于冠状 T1 加权图像。为了比较,标记 VOI 的同一位放射科医生也在每个切片上手动分割肿块。使用重叠度量来量化自动方法的性能,定义为计算机和手动分割体积的交集与手动分割体积的比值。化疗前后的肿块重叠度量分别为 0.81 +/- 0.13(平均值 +/- s.d.)和 0.71 +/- 0.22。计算机和放射科医生估计的体积减少百分比(PVR)分别为 55.5 +/- 43.0%(平均值 +/- s.d.)和 57.8 +/- 51.3%。配对学生 t 检验表明,计算机和放射科医生估计的平均 PVR 之间的差异没有达到统计学意义(p = 0.641)。自动肿块分割方法有可能帮助医生监测治疗后乳腺肿块的体积变化。
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