Volumetric assessment of unaffected parenchyma and Wilms’ tumours: analysis of response to chemotherapy and surgery using a semi-automated segmentation algorithm in children with renal neoplasms
| Autor: | Ahmed Shalabi, Nicolás Fernández, Wayne Lee, Joseph M. Gleason, Afsaneh Amirabadi, Jeffrey Traubici, Armando J. Lorenzo, Jack Brzezinski, Anne-Sophie Blais, Mandy Rickard |
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| Rok vydání: | 2020 |
| Předmět: |
Chemotherapy
medicine.medical_specialty business.industry Urology medicine.medical_treatment Automated segmentation Renal function Wilms' tumor medicine.disease Surgical planning Nephrectomy 030218 nuclear medicine & medical imaging Renal neoplasm Surgery 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Parenchyma medicine business |
| Zdroj: | BJU International. 125:695-701 |
| ISSN: | 1464-4096 |
| DOI: | 10.1111/bju.15026 |
| Popis: | Objective To present our proof of concept with semi-automatic image recognition/segmentation technology for calculation of tumour/parenchyma volume. Methods We reviewed Wilms' tumours (WTs) between 2000 and 2018, capturing computed tomography images at baseline, after neoadjuvant chemotherapy (NaC) and postoperatively. Images were uploaded into MATLAB-3-D volumetric image processing software. The program was trained by two clinicians who supervised the demarcation of tumour and parenchyma, followed by automatic recognition and delineation of tumour margins on serial imaging, and differentiation from uninvolved renal parenchyma. Volume was automatically calculated for both. Results During the study period, 98 patients were identified. Of these, based on image quality and availability, 32 (38 affected moieties) were selected. Most patients (65%) were girls, diagnosed at age 50 ± 37 months of age. NaC was employed in 64% of patients. Surgical management included 27 radical and 11 partial nephrectomies. Automated volume assessment demonstrated objective response to NaC for unilateral and bilateral tumours (68 ± 20% and 53 ± 39%, respectively), as well as preservation on uninvolved parenchyma with partial nephrectomy (70 ± 46 cm3 at presentation to 57 ± 41 cm3 post-surgery). Conclusion Volumetric analysis is feasible and allows objective assessment of tumour and parenchyma volume in response to chemotherapy and surgery. Our data show changes after therapy that may be otherwise difficult to quantify. Use of such technology may improve surgical planning and quantification of response to treatment, as well as serving as a tool to predict renal reserve and long-term changes in renal function. |
| Databáze: | OpenAIRE |
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