Armato Samuel G, Li Ping, Husain Aliya N, Straus Christopher, Khanwalkar Ashoke, Kindler Hedy L, Vigneswaran Wickii T
Department of Radiology, The University of Chicago, Chicago, IL, USA.
Department of Radiology, The University of Chicago, Chicago, IL, USA.
Lung Cancer. 2015 Mar;87(3):278-82. doi: 10.1016/j.lungcan.2014.11.019. Epub 2015 Jan 20.
Tumor volume promises to become a more important factor in patient management. Mesothelioma, with its unique morphology and complex growth pattern, presents a challenging target for tumor volumetrics derived from computed tomography (CT) scans. This study evaluated the validity of image-based mesothelioma tumor volume against the physical volume of the tumor bulk captured by the images.
Twenty-eight patients underwent CT scanning prior to pleurectomy/decortication with an intent to achieve a macroscopic complete resection. A radiologist manually outlined the tumor border in all CT sections in which tumor appeared in the pre-surgery scan. CT-based tumor volume was computed as the number of image pixels enclosed by all tumor outlines across all sections in the scan multiplied by the physical dimensions of the voxel of tissue captured by each image pixel. The gross tumor specimen volume was measured ex vivo through a water-displacement technique. Correlation between CT volume and pathology volume was calculated.
A correlation coefficient r-squared value of 0.66 was found between CT-based tumor volume and gross tumor specimen volume. Differences between the mean volume (either CT volume or pathology volume) across tumors of different T stages did not achieve statistical significance.
Despite a modest correlation between CT-based tumor volume and gross tumor specimen volume, image-based volumetry for mesothelioma is not straightforward-perhaps, in part, due to the challenges of distinguishing tumor borders from adjacent structures and perhaps, in part, due to a complex pathologic reference standard.
肿瘤体积有望在患者管理中成为一个更重要的因素。间皮瘤具有独特的形态和复杂的生长模式，对于基于计算机断层扫描（CT）图像的肿瘤体积测量而言是一个具有挑战性的目标。本研究评估了基于图像的间皮瘤肿瘤体积与图像所捕获的肿瘤实体物理体积之间的有效性。
28例患者在进行胸膜切除术/去皮质术之前接受了CT扫描，目的是实现宏观完全切除。一名放射科医生在术前扫描中出现肿瘤的所有CT切片上手动勾勒出肿瘤边界。基于CT的肿瘤体积通过将扫描中所有切片上所有肿瘤轮廓所包围的图像像素数量乘以每个图像像素所捕获的组织体素的物理尺寸来计算。通过水置换技术在体外测量大体肿瘤标本体积。计算CT体积与病理体积之间的相关性。
基于CT的肿瘤体积与大体肿瘤标本体积之间的相关系数r平方值为0.66。不同T分期肿瘤的平均体积（CT体积或病理体积）之间的差异未达到统计学意义。
尽管基于CT的肿瘤体积与大体肿瘤标本体积之间存在适度的相关性，但间皮瘤基于图像的体积测量并非易事——部分原因可能是将肿瘤边界与相邻结构区分开来存在挑战，部分原因可能是病理参考标准复杂。
