Computerized Analysis of Mesothelioma on CT Scans

描述（由申请人提供）：拟议研究的广泛，长期目标是开发一个全自动，计算机化的系统，以帮助放射科医生在螺旋计算机断层扫描（CT）中定量评估胸膜疾病。这种系统将产生的客观疾病量化预计将提供有关疾病进展或疾病对治疗反应的有价值的信息。这些信息将用于指导患者治疗或在临床试验中评估治疗药物的疗效。这个特殊的研究将集中在一个特殊的胸膜基础疾病，恶性胸膜间皮瘤。放射科医生必须在CT扫描中检查肺与胸壁或纵隔之间的解剖区域，以评估间皮瘤的范围，间皮瘤表现为胸膜增厚。目前，间皮瘤严重程度的评估是基于在几个图像位置人工测量胸膜厚度；这种方法代表了一个粗糙、乏味的过程，它受到进行测量的观察者的主观性和可变性的影响。自动化和半自动方法的发展，在CT扫描的每个半胸中，划定肺边界，划定胸壁和纵隔，并量化这些解剖结构之间的差异，作为胸膜厚度的测量，有望促进有效，客观的胸膜厚度评估间皮瘤肿瘤。这种一致性方法的效用通过它们在时间顺序扫描中的应用而得到强调，其中肿瘤大小随时间的比较是为了确定疾病进展的速度或疾病对特定治疗方案的反应。本研究的假设是，计算机技术可以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.