Zahel Tina, Wildgruber Moritz, Ardon Roberto, Schuster Tibor, Rummeny Ernst J, Dobritz Martin
Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, München, Germany.
J Comput Assist Tomogr. 2013 Jul-Aug;37(4):577-82. doi: 10.1097/RCT.0b013e31828f0baa.
This study aimed to evaluate a novel segmentation software for automated liver volumetry and segmentation regarding segmentation speed and interobserver variability.
Computed tomographic scans of 20 patients without underlying liver disease and 10 patients with liver metastasis from colorectal cancer were analyzed by a novel segmentation software. Liver segmentation was performed after manual placement of specific landmarks into 9 segments according to the Couinaud model as well as into 4 segments, the latter being import for surgery planning. Time for segmentation was measured and the obtained segmental and total liver volumes between the different readers were compared calculating intraclass correlations (ICCs). Volumes of liver tumor burden were evaluated similarly.
Liver segmentation could be performed rapidly 3 minutes or less. Comparison of total liver volumes revealed a perfect ICC of greater than 0.997. Segmental liver volumes within the 9-part segmentation provided fair to moderate correlation for the left lobe and good to excellent correlations for the right lobe. When applying a 4-part segmentation relevant to clinical practice, strong to perfect agreement was observed. Similarly tumor volumes showed perfect ICC (>0.998).
Rapid determination of total and segmental liver volumes can be obtained using a novel segmentation software suitable for daily clinical practice.
本研究旨在评估一种用于肝脏自动容积测量和分割的新型分割软件在分割速度和观察者间变异性方面的表现。
采用一种新型分割软件对20例无潜在肝脏疾病的患者及10例结直肠癌肝转移患者的计算机断层扫描图像进行分析。根据Couinaud模型，在手动放置特定标志点将肝脏分为9个段以及4个段（后者对手术规划很重要）后进行肝脏分割。测量分割时间，并比较不同阅片者获得的各段肝脏体积和肝脏总体积，计算组内相关系数（ICC）。对肝肿瘤负荷体积进行类似评估。
肝脏分割可在3分钟或更短时间内快速完成。肝脏总体积比较显示ICC大于0.997，具有完美相关性。9段分割中各段肝脏体积，左叶相关性为中等，右叶相关性良好至优秀。应用与临床实践相关的4段分割时，观察到高度至完美的一致性。同样，肿瘤体积显示ICC大于0.998，具有完美相关性。
使用适用于日常临床实践的新型分割软件可快速测定肝脏总体积和各段体积。
