Kumamaru Kanako K, George Elizabeth, Aghayev Ayaz, Saboo Sachin S, Khandelwal Ashish, Rodríguez-López Sara, Cai Tianrun, Jiménez-Carretero Daniel, Estépar Raúl San José, Ledesma-Carbayo Maria J, González Germán, Rybicki Frank J
From the *Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital, Boston, MA; †Department of Radiology, Juntendo University, Tokyo, Japan; ‡Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX; §Biomedical Image Technologies, Universidad Politécnica de Madrid & CIBER-BBN, Madrid, Spain; ∥Surgical Planning Laboratory, Brigham and Women's Hospital, Boston; and ¶Madrid-MIT M+Visión Consortium, Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA; and #Department of Radiology, The Ottawa Hospital and Ottawa University, Ottawa, Ontario, Canada.
J Comput Assist Tomogr. 2016 May-Jun;40(3):387-92. doi: 10.1097/RCT.0000000000000375.
The aim of this study was to prospectively test the performance and potential for clinical integration of software that automatically calculates the right-to-left ventricular (RV/LV) diameter ratio from computed tomography pulmonary angiography images.
Using 115 computed tomography pulmonary angiography images that were positive for acute pulmonary embolism, we prospectively evaluated RV/LV ratio measurements that were obtained as follows: (1) completely manual measurement (reference standard), (2) completely automated measurement using the software, and (3 and 4) using a customized software interface that allowed 2 independent radiologists to manually adjust the automatically positioned calipers.
Automated measurements underestimated (P < 0.001) the reference standard (1.09 [0.25] vs1.03 [0.35]). With manual correction of the automatically positioned calipers, the mean ratio became closer to the reference standard (1.06 [0.29] by read 1 and 1.07 [0.30] by read 2), and the correlation improved (r = 0.675 to 0.872 and 0.887). The mean time required for manual adjustment (37 [20] seconds) was significantly less than the time required to perform measurements entirely manually (100 [23] seconds).
Automated CT RV/LV diameter ratio software shows promise for integration into the clinical workflow for patients with acute pulmonary embolism.
本研究旨在前瞻性地测试一种能从计算机断层扫描肺动脉造影图像中自动计算右心室与左心室（RV/LV）直径比的软件的性能及临床整合潜力。
我们使用115例急性肺栓塞阳性的计算机断层扫描肺动脉造影图像，前瞻性地评估通过以下方式获得的RV/LV比值测量结果：（1）完全手动测量（参考标准），（2）使用该软件进行完全自动化测量，以及（3和4）使用定制软件界面，让2名独立放射科医生手动调整自动定位的卡尺。
自动化测量结果低于（P < 0.001）参考标准（1.09 [0.25] 对比1.03 [0.35]）。通过手动校正自动定位的卡尺，平均比值更接近参考标准（第1次读数为1.06 [0.29]，第2次读数为1.07 [0.30]），且相关性有所提高（r = 0.675至0.872以及0.887）。手动调整所需的平均时间（37 [20] 秒）显著少于完全手动测量所需的时间（100 [23] 秒）。
自动化CT RV/LV直径比软件显示出有望整合到急性肺栓塞患者的临床工作流程中。
