Yan Pengfei, Yan Ling, Hu Tingting, Zhang Zhen, Feng Jun, Zhao Hongyang
Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Computer Science, University of Northern BC, Prince George, Canada.
PeerJ. 2016 Apr 11;4:e1921. doi: 10.7717/peerj.1921. eCollection 2016.
Background. The traumatic epidural hematoma (tEDH) volume is often used to assist in tEDH treatment planning and outcome prediction. ABC/2 is a well-accepted volume estimation method that can be used for tEDH volume estimation. Previous studies have proposed different variations of ABC/2; however, it is unclear which variation will provide a higher accuracy. Given the promising clinical contribution of accurate tEDH volume estimations, we sought to assess the accuracy of several ABC/2 variations in tEDH volume estimation. Methods. The study group comprised 53 patients with tEDH who had undergone non-contrast head computed tomography scans. For each patient, the tEDH volume was automatically estimated by eight ABC/2 variations (four traditional and four newly derived) with an in-house program, and results were compared to those from manual planimetry. Linear regression, the closest value, percentage deviation, and Bland-Altman plot were adopted to comprehensively assess accuracy. Results. Among all ABC/2 variations assessed, the traditional variations y = 0.5 × A 1 B 1 C 1 (or A 2 B 2 C 1) and the newly derived variations y = 0.65 × A 1 B 1 C 1 (or A 2 B 2 C 1) achieved higher accuracy than the other variations. No significant differences were observed between the estimated volume values generated by these variations and those of planimetry (p > 0.05). Comparatively, the former performed better than the latter in general, with smaller mean percentage deviations (7.28 ± 5.90% and 6.42 ± 5.74% versus 19.12 ± 6.33% and 21.28 ± 6.80%, respectively) and more values closest to planimetry (18/53 and 18/53 versus 2/53 and 0/53, respectively). Besides, deviations of most cases in the former fell within the range of <10% (71.70% and 84.91%, respectively), whereas deviations of most cases in the latter were in the range of 10-20% and >20% (90.57% and 96.23, respectively). Discussion. In the current study, we adopted an automatic approach to assess the accuracy of several ABC/2 variations for tEDH volume estimation. Our initial results showed that the variations y = 0.5 × A 1 B 1 C 1 (or A 2 B 2 C 1) performed better than the other traditional variations, suggesting that the adjusted depth is favorable. In addition, linear regression has been shown to be useful for improving the estimation accuracy of the ABC/2 method, and future studies are warranted to investigate the applicability of such linear regression-derived formulas for clinical application.
背景。创伤性硬膜外血肿（tEDH）体积常用于辅助tEDH治疗方案的制定和预后预测。ABC/2是一种广泛认可的体积估计方法，可用于tEDH体积估计。以往的研究提出了ABC/2的不同变体；然而，尚不清楚哪种变体将提供更高的准确性。鉴于准确的tEDH体积估计具有可观的临床价值，我们试图评估几种ABC/2变体在tEDH体积估计中的准确性。方法。研究组包括53例接受了非增强头部计算机断层扫描的tEDH患者。对于每位患者，使用内部程序通过八种ABC/2变体（四种传统变体和四种新推导变体）自动估计tEDH体积，并将结果与手动平面测量法的结果进行比较。采用线性回归、最接近值、百分比偏差和Bland-Altman图来综合评估准确性。结果。在评估的所有ABC/2变体中，传统变体y = 0.5×A1B1C1（或A2B2C1）和新推导变体y = 0.65×A1B1C1（或A2B2C1）比其他变体具有更高的准确性。这些变体生成的估计体积值与平面测量法的估计体积值之间未观察到显著差异（p>0.05）。相比之下，前者总体上比后者表现更好，平均百分比偏差更小（分别为7.28±5.90%和6.42±5.74%，而后者分别为19.12±6.33%和21.28±6.80%），并且更接近平面测量法的值（分别为18/53和18/53，而后者分别为2/53和0/53）。此外，前者大多数病例的偏差落在<10%的范围内（分别为71.70%和84.91%），而后者大多数病例的偏差在10 - 20%和>20%的范围内（分别为90.57%和96.23%）。讨论。在本研究中，我们采用自动方法评估几种ABC/2变体在tEDH体积估计中的准确性。我们的初步结果表明，变体y = 0.5×A1B1C（或A2B2C1）比其他传统变体表现更好，表明调整后的深度是有利的。此外，线性回归已被证明有助于提高ABC/2方法的估计准确性，未来的研究有必要探讨这种线性回归推导公式在临床应用中的适用性。
