Computerized Analysis of Mesothelioma on CT Scans

描述（由申请人提供）：拟议研究的广泛、长期目标是开发一种完全自动化的计算机化系统，该系统将协助放射科医生在螺旋计算机断层扫描（CT）扫描中对胸膜疾病进行定量评估。这种系统产生的客观疾病量化有望提供有关疾病进展或疾病对治疗的反应的有价值的信息。该信息将用于指导患者治疗或在临床试验期间评估治疗药物的功效。这项具体研究将重点关注一种特定的胸膜疾病，即恶性胸膜间皮瘤。放射科医生必须通过 CT 扫描检查肺部和胸壁或纵隔之间的解剖区域，以评估间皮瘤的范围（表现为胸膜增厚）。目前，间皮瘤严重程度的评估是基于在多个图像位置手动测量胸膜厚度；这种方法代表了一个粗糙、乏味的过程，并且受到进行测量的观察者的主观性和可变性的影响。自动和半自动方法的开发，在 CT 扫描的每个半胸中，描绘肺边界，描绘胸壁和纵隔，并量化这些解剖结构之间的差异作为胸膜厚度的测量，预计将有助于有效、客观地评估胸膜厚度，以评估间皮瘤。这种一致方法的实用性通过它们在时间顺序扫描中的应用而得到强调，其中对肿瘤大小随时间的变化进行比较，以确定疾病进展的速率或疾病对特定治疗方案的反应。本研究的假设是，可以开发计算机化技术来帮助放射科医生和临床医生对间皮瘤肿瘤进行可靠、一致和可重复的量化，作为初始分期和后续治疗反应的客观参数。

DESCRIPTION (provided by applicant): The broad, long term objective of the proposed research is to develop a fully automated, computerized system that will assist radiologists in the quantitative assessment of pleural-based diseases in helical computed tomography (CT) scans. The objective disease quantification that such a system would produce is expected to provide valuable information regarding disease progression or the response of disease to treatment. This information would be used to guide patient treatment or gauge the efficacy of therapeutic agents during clinical trials. This specific study will focus on one particular pleural-based disease, malignant pleural mesothelioma. Radiologists must inspect the anatomic region between the lungs and the chest wall or the mediastinum on CT scans to evaluate the extent of mesothelioma, which presents as a thickening of the pleura. Currently, assessment of mesothelioma severity is based on manual measurements of the pleural thickness made at several image locations; this approach represents a coarse, tedious process that suffers from subjectivity and variability among observers who make the measurements. The development of automated and semi- automated methods that, in each hemithorax of a CT scan, delineate the lung border, delineate the chest wall and mediastinum, and quantify the differences between these anatomical structures as a measure of pleural thickness, is expected to facilitate the efficient, objective assessment of pleural thickness for the evaluation of mesothelioma tumor. The utility of such consistent methods is accentuated by their application to temporally sequential scans, in which a comparison of tumor size over time is made to determine the rate of disease progression or the response of disease to a specific treatment regimen. The hypothesis of this study is that computerized techniques can be developed to assist radiologists and clinicians in the reliable, consistent, and reproducible quantification of mesothelioma tumor as an objective parameter for initial staging and subsequent treatment response.