Assessing splenomegaly: automated volumetric analysis of the spleen.
Assessing splenomegaly: automated volumetric analysis of the spleen.
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DOI：
10.1016/j.acra.2013.01.011
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发表时间：
2013-06
影响因子：
4.8
通讯作者：
Summers, Ronald M.
中科院分区：
文献类型：
--
作者：
Linguraru, Marius George;Sandberg, Jesse K.;Jones, Elizabeth C.;Summers, Ronald M.
定义系统体积阈值以识别和分级脾肿大，并回顾性评价放射科医生评估计算机断层扫描图像数据中脾肿大的性能。开发了一种临床工具，用于从172例对比增强临床CT研究中分割脾脏。经放射学证实，正常脾45例，脾肿大127例。使用重叠/误差将脾脏体积与手动测量值进行比较。轻度/巨大脾肿大的体积阈值定义为高于健康人群平均脾体积的1/2.5标准差。根据共识报告对阈值进行了验证。回顾性评价了放射科医师在评估脾肿大方面的表现。脾脏的自动分割是稳健的，体积重叠/误差为95.2/3.3%。对于正常/脾肿大亚组，手动和自动分割之间没有显著差异（p>0.2）。观察者间和手动自动测量之间的相关性相当（R=0.99）。正常脾脏体积平均为236.89± 77.58ml。脾肿大的平均体积为1004.75±644.27 ml。使用314.47/430.84 ml的体积阈值来定义轻度/巨大脾肿大（+/−18.86 ml 95% CI）。23.25%（n=40）的诊断病例放射科医师不同意。脾肿大检测的体积标准的ROC曲线下面积为0.96。以体积阈值作为参考标准，放射科医师检测所有/轻度/巨大脾肿大的敏感性分别为95.0/66.6/99.0%，特异性为78.0%。本文介绍了自动脾容积评估对脾肿大的鉴别和分级的方法。体积阈值与脾肿大的临床解释非常匹配，并且与当前临床实践中常用的脾脏头尾高度测量或目视检查相比，可以改善脾肿大的检测。
To define systematic volumetric thresholds to identify and grade splenomegaly, and retrospectively evaluate the performance of radiologists to assess splenomegaly in computed tomography image data. A clinical tool was developed to segment spleens from 172 contrast-enhanced clinical CT studies. There were 45 normal and 127 splenomegaly cases confirmed by radiological reports. Spleen volumes were compared to manual measurements using overlap/error. Volumetric thresholds for mild/massive splenomegaly were defined at 1/2.5 standard deviations above the average splenic volume of the healthy population. The thresholds were validated against consensus reports. The performance of radiologists in assessing splenomegaly was retrospectively evaluated. The automated segmentation of spleens was robust with volume overlap/error of 95.2/3.3%. There were no significant differences (p>0.2) between manual and automated segmentations for either normal/splenomegaly subgroups. Comparable correlations between interobserver and manual-automated measurements were found (R=0.99 for all). The average volume of normal spleens was 236.89±77.58 ml. For splenomegaly, average volume was 1004.75±644.27 ml. Volumetric thresholds of 314.47/430.84 ml were used to define mild/massive splenomegaly (+/−18.86 ml 95% CI). Radiologists disagreed in 23.25% (n=40) of the diagnosed cases. The area under the ROC curve of the volumetric criterion for splenomegaly detection was 0.96. Using the volumetric thresholds as the reference standard, the sensitivity of radiologists in detecting all/mild/massive splenomegaly was 95.0/66.6/99.0% at 78.0% specificity, respectively. Thresholds for the identification and grading of splenomegaly from automatic volumetric spleen assessment were introduced. The volumetric thresholds match well with clinical interpretations for splenomegaly and may improve splenomegaly detection compared with splenic cephalocaudal height measurements or visual inspection commonly used in current clinical practice.
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