Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bldg 10, Room 1C368X, MSC 1182, Bethesda, MD 20892-1182, USA.
Radiology. 2010 Jun;255(3):707-20. doi: 10.1148/radiol.10090877.
Polyp size is a critical biomarker for clinical management. Larger polyps have a greater likelihood of being or of becoming an adenocarcinoma. To balance the referral rate for polypectomy against the risk of leaving potential cancers in situ, sizes of 6 and 10 mm are increasingly being discussed as critical thresholds for clinical decision making (immediate polypectomy versus polyp surveillance) and have been incorporated into the consensus CT Colonography Reporting and Data System (C-RADS). Polyp size measurement at optical colonoscopy, pathologic examination, and computed tomographic (CT) colonography has been studied extensively but the reported precision, accuracy, and relative sizes have been highly variable. Sizes measured at CT colonography tend to lie between those measured at optical colonoscopy and pathologic evaluation. The size measurements are subject to a variety of sources of error associated with image acquisition, display, and interpretation, such as partial volume averaging, two- versus three-dimensional displays, and observer variability. This review summarizes current best practices for polyp size measurement, describes the role of automated size measurement software, discusses how to manage the measurement uncertainties, and identifies areas requiring further research.
息肉大小是临床管理的一个关键生物标志物。较大的息肉更有可能是或成为腺癌。为了平衡息肉切除术的转诊率与潜在癌症原位遗留的风险，6 毫米和 10 毫米的大小越来越多地被讨论作为临床决策（立即进行息肉切除术与息肉监测）的关键阈值，并已被纳入共识 CT 结肠成像报告和数据系统（C-RADS）。光学结肠镜检查、病理检查和计算机断层扫描（CT）结肠成像中的息肉大小测量已经得到了广泛的研究，但报告的精度、准确性和相对大小差异很大。CT 结肠成像测量的大小介于光学结肠镜检查和病理评估测量的大小之间。这些大小测量受到与图像获取、显示和解释相关的各种误差源的影响，例如部分容积平均、二维与三维显示以及观察者的变异性。本综述总结了目前息肉大小测量的最佳实践，描述了自动大小测量软件的作用，讨论了如何管理测量不确定性，并确定了需要进一步研究的领域。
