Semiautomated segmentation for volumetric analysis of intratumoral ethiodol uptake and subsequent tumor necrosis after chemoembolization
Autor: | Wayne L. Monsky, Ramsey D. Badawi, Shaun Loh, Isaac H. Kim, Larry Stuart Deutsch, Chin-Shang Li, Tamara A. Greasby |
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Rok vydání: | 2010 |
Předmět: |
Male
medicine.medical_specialty Carcinoma Hepatocellular Wilcoxon signed-rank test Intraclass correlation medicine.medical_treatment Interobserver reproducibility Antineoplastic Agents Pilot Projects Carcinoid Tumor Statistics Nonparametric Ethiodized Oil Automation Necrosis medicine Humans Radiology Nuclear Medicine and imaging Embolization Chemoembolization Therapeutic Aged Retrospective Studies Aged 80 and over Reproducibility business.industry Liver Neoplasms Reproducibility of Results General Medicine Middle Aged Treatment Outcome Response Evaluation Criteria in Solid Tumors Radiographic Image Interpretation Computer-Assisted Female Insulinoma Radiology Nuclear medicine business Colorectal Neoplasms Tomography X-Ray Computed After treatment Software |
Zdroj: | AJR. American journal of roentgenology. 195(5) |
ISSN: | 1546-3141 |
Popis: | Linear measurements, such as those described by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria, may be limited for assessment of response after transarterial chemoembolization (TACE). The purpose of this pilot study was to show intra- and interobserver reproducibility of volumetric measurements of Ethiodol (ethiodized oil) seen within tumor 24 hours after TACE and of necrotic and viable tumor 1 month after treatment. Volumetric measurements are compared with linear measurements and survival outcomes.Between 2006 and 2009, 37 consecutive TACE procedures were performed in 27 patients with hepatic malignancies. CT images obtained 24 hours and 1 month after TACE were retrospectively analyzed. Three observers measured volumes twice. Intraoperator reproducibility was determined using Wilcoxon's signed rank test to assess whether the difference in each volumetric measurement approaches zero. The intraclass correlation coefficient (ICC) and Bland-Altman plots were used to determine interoperator reproducibility. Survival data were retrospectively obtained from the electronic medical record.Good intraobserver reproducibility and interobserver reproducibility (p0.05, ICC0.9, respectively) were shown for Ethiodol, whole tumor, and necrotic tumor volumes. The volume of Ethiodol correlated with subsequent necrotic tumor volume (p = 0.009), reduction in whole tumor volume (p = 0.004), and patient survival (p = 0.029). Kaplan-Meier curves suggest that Ethiodol accumulation in more than 50% of the tumor and a 10% or greater increase in the volume of necrotic tumor correlated with survival (p = 0.028 and 0.047, respectively).Semiautomated volumetric analysis can be performed with good intra- and interobserver reproducibility. The volume of Ethiodol accumulated in the tumor after TACE correlates with subsequent necrosis. These early measurements may predict survival outcomes. |
Databáze: | OpenAIRE |
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