Christe Andreas, Brönnimann Alain, Vock Peter
Department of Diagnostic, Interventional and Pediatric Radiology, University of Bern, Inselspital, Bern, Switzerland.
Acta Radiol. 2014 Feb;55(1):54-61. doi: 10.1177/0284185113492454. Epub 2013 Jul 17.
A precise detection of volume change allows for better estimating the biological behavior of the lung nodules. Postprocessing tools with automated detection, segmentation, and volumetric analysis of lung nodules may expedite radiological processes and give additional confidence to the radiologists.
To compare two different postprocessing software algorithms (LMS Lung, Median Technologies; LungCARE®, Siemens) in CT volumetric measurement and to analyze the effect of soft (B30) and hard reconstruction filter (B70) on automated volume measurement.
Between January 2010 and April 2010, 45 patients with a total of 113 pulmonary nodules were included. The CT exam was performed on a 64-row multidetector CT scanner (Somatom Sensation, Siemens, Erlangen, Germany) with the following parameters: collimation, 24x1.2 mm; pitch, 1.15; voltage, 120 kVp; reference tube current-time, 100 mAs. Automated volumetric measurement of each lung nodule was performed with the two different postprocessing algorithms based on two reconstruction filters (B30 and B70). The average relative volume measurement difference (VME%) and the limits of agreement between two methods were used for comparison.
At soft reconstruction filters the LMS system produced mean nodule volumes that were 34.1% (P < 0.0001) larger than those by LungCARE® system. The VME% was 42.2% with a limit of agreement between -53.9% and 138.4%.The volume measurement with soft filters (B30) was significantly larger than with hard filters (B70); 11.2% for LMS and 1.6% for LungCARE®, respectively (both with P < 0.05). LMS measured greater volumes with both filters, 13.6% for soft and 3.8% for hard filters, respectively (P < 0.01 and P > 0.05).
There is a substantial inter-software (LMS/LungCARE®) as well as intra-software variability (B30/B70) in lung nodule volume measurement; therefore, it is mandatory to use the same equipment with the same reconstruction filter for the follow-up of lung nodule volume.
精确检测体积变化有助于更好地评估肺结节的生物学行为。具备自动检测、分割和肺结节体积分析功能的后处理工具可加快放射学流程，并为放射科医生提供更多信心。
比较两种不同的后处理软件算法（LMS Lung，Median Technologies公司；LungCARE®，西门子公司）在CT体积测量中的表现，并分析软组织（B30）和硬重建滤波器（B70）对自动体积测量的影响。
纳入2010年1月至2010年4月期间的45例患者，共113个肺结节。CT检查使用64排多层螺旋CT扫描仪（Somatom Sensation，西门子公司，德国埃尔朗根），参数如下：准直，24×1.2毫米；螺距，1.15；电压，120 kVp；参考管电流-时间，100 mAs。基于两种重建滤波器（B30和B70），使用两种不同的后处理算法对每个肺结节进行自动体积测量。采用平均相对体积测量差异（VME%）和两种方法之间的一致性界限进行比较。
在软组织重建滤波器下，LMS系统测得的平均结节体积比LungCARE®系统大34.1%（P < 0.0001）。VME%为42.2%，一致性界限在-53.9%至138.4%之间。软组织滤波器（B30）的体积测量值显著大于硬组织滤波器（B70）；LMS系统分别为11.2%，LungCARE®系统为1.6%（均P < 0.05）。两种滤波器下LMS测得的体积均更大，软组织滤波器为13.6%，硬组织滤波器为3.8%（分别为P < 0.01和P > 0.05）。
在肺结节体积测量中，软件间（LMS/LungCARE®）以及软件内（B30/B70）均存在显著差异；因此，在肺结节体积随访中，必须使用相同设备和相同重建滤波器。
