Zhang Yi-Hua, Fischer Michael A, Lehmann Henrik, Johnsson Åse, Rouvelas Ioannis, Herlin Gunnar, Lundell Lars, Brismar Torkel B
Department of Diagnostic Radiology and Karolinska Institutet, Karolinska University Hospital, CLINTEC, Stockholm, Sweden.
Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden.
BMC Med Imaging. 2019 Feb 15;19(1):17. doi: 10.1186/s12880-019-0317-5.
The clinical and research value of Computed Tomography (CT) volumetry of esophageal cancer tumor size remains controversial. Development in CT technique and image analysis has made CT volumetry less cumbersome and it has gained renewed attention. The aim of this study was to assess esophageal tumor volume by semi-automatic measurements as compared to manual.
A total of 23 esophageal cancer patients (median age 65, range 51-71), undergoing CT in the portal-venous phase for tumor staging, were retrospectively included between 2007 and 2012. One radiology resident and one consultant radiologist measured the tumor volume by semiautomatic segmentation and manual segmentation. Reproducibility of the respective measurements was assessed by intraclass correlation coefficients (ICC) and by average deviation from mean.
Mean tumor volume was 46 ml (range 5-137 ml) using manual segmentation and 42 ml (range 3-111 ml) using semiautomatic segmentation. Semiautomatic measurement provided better inter-observer agreement than traditional manual segmentation. The ICC was significantly higher for semiautomatic segmentation in comparison to manual segmentation (0.86, 0.56, p < 0.01). The average absolute percentage difference from mean was reduced from 24 to 14% (p < 0.001) when using semiautomatic segmentation.
Semiautomatic analysis outperforms manual analysis for assessment of esophageal tumor volume, improving reproducibility.
食管癌肿瘤大小的计算机断层扫描（CT）容积测量的临床和研究价值仍存在争议。CT技术和图像分析的发展使CT容积测量变得不那么繁琐，因而重新受到关注。本研究的目的是通过半自动测量与手动测量来评估食管肿瘤体积。
回顾性纳入2007年至2012年间共23例食管癌患者（中位年龄65岁，范围51 - 71岁），这些患者在门静脉期接受CT检查以进行肿瘤分期。一名放射科住院医师和一名放射科顾问医师通过半自动分割和手动分割测量肿瘤体积。通过组内相关系数（ICC）和平均偏差评估各自测量的可重复性。
手动分割测得的平均肿瘤体积为46毫升（范围5 - 137毫升），半自动分割测得的平均肿瘤体积为42毫升（范围3 - 111毫升）。与传统手动分割相比，半自动测量提供了更好的观察者间一致性。半自动分割的ICC显著高于手动分割（0.86对0.56，p < 0.01）。使用半自动分割时，平均绝对百分比偏差从24%降至14%（p < 0.001）。
半自动分析在评估食管肿瘤体积方面优于手动分析，提高了可重复性。
