Resources Required for Semi-Automatic Volumetric Measurements in Metastatic Chordoma: Is Potentially Improved Tumor Burden Assessment Worth the Time Burden?
Resources Required for Semi-Automatic Volumetric Measurements in Metastatic Chordoma: Is Potentially Improved Tumor Burden Assessment Worth the Time Burden?
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DOI：
10.1007/s10278-015-9846-9
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发表时间：
2016-06-01
影响因子：
4.4
通讯作者：
Folio, Les R.
中科院分区：
文献类型：
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作者：
Fenerty, Kathleen E.;Patronas, Nicholas J.;Folio, Les R.
实体瘤疗效评价标准（RECIST）是评估恶性实体瘤患者治疗疗效的现行标准;然而，体积评估被认为更能代表实际肿瘤大小，因此在预测患者结局方面具有上级优势。我们对21例脉络膜炎患者的所有原发性和转移性病变进行了分割，以与RECIST进行比较。原发性肿瘤在MR上被分割，并由神经放射科医生进行验证。转移性病变在CT上被分割，并由普通放射科医生进行验证。我们估计了研究助理使用PACS（v12.0，Carestream，罗切斯特，纽约州）中可用的半自动体积分割工具分割所有原发性和转移性脉络膜病变的时间，以及放射科医生验证分割所需的时间。我们还报告了CT转移性病变半自动分割的成功率和导出数据所需的时间。此外，我们还讨论了体积分割工作流程在研究和临床环境中的可行性。研究助理花了大约65小时分割21例患者的435处病变。这导致总共1349个分割（每个病变平均2.89分钟）和超过13，000个数据点。神经放射科医师和普通放射科医师确认分割的合并时间为每例患者45.7分钟。所有患者的导出时间总计仅为6小时，为数据管理员和肿瘤学家提供了节省时间的机会。也许成本中立的资源重新分配可以帮助获得与我们的示例工作流并行的卷。我们的研究结果将为研究人员提供PACS内体积评估所需的基准资源，并帮助机构为未来的体积评估标准做好准备。
The Response Evaluation Criteria in Solid Tumors (RECIST) is the current standard for assessing therapy response in patients with malignant solid tumors; however, volumetric assessments are thought to be more representative of actual tumor size and hence superior in predicting patient outcomes. We segmented all primary and metastatic lesions in 21 chordoma patients for comparison to RECIST. Primary tumors were segmented on MR and validated by a neuroradiologist. Metastatic lesions were segmented on CT and validated by a general radiologist. We estimated times for a research assistant to segment all primary and metastatic chordoma lesions using semi-automated volumetric segmentation tools available within our PACS (v12.0, Carestream, Rochester, NY), as well as time required for radiologists to validate the segmentations. We also report success rates of semi-automatic segmentation in metastatic lesions on CT and time required to export data. Furthermore, we discuss the feasibility of volumetric segmentation workflow in research and clinical settings. The research assistant spent approximately 65 h segmenting 435 lesions in 21 patients. This resulted in 1349 total segmentations (average 2.89 min per lesion) and over 13,000 data points. Combined time for the neuroradiologist and general radiologist to validate segmentations was 45.7 min per patient. Exportation time for all patients totaled only 6 h, providing time-saving opportunities for data managers and oncologists. Perhaps cost-neutral resource reallocation can help acquire volumes paralleling our example workflow. Our results will provide researchers with benchmark resources required for volumetric assessments within PACS and help prepare institutions for future volumetric assessment criteria.