转移病灶CT检查PACS半自动病变管理分析  

Using semi-automatic lesions of PACS management to analysis CT metastatic lesions

作　　者：张喜雨[1] 林炜炜[2] 张晴晴[2] 陈刚[3] ZHANG Xi-yu LIN Wei-wei ZHANG Qing-qing CHEN Gang(Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, P. R. China Public Health Section, Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, P. R. China)

机构地区：[1]山东大学附属省立医院远程医学中心,山东济南250021 [2]山东大学附属省立医院统计与病案管理科,山东济南250021 [3]山东省肿瘤医院公共卫生科,山东济南250117

出　　处：《中华肿瘤防治杂志》2017年第17期1245-1248,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的采用影像归档和通信系统(picture archiving and communication systems,PACS)中的半自动病变管理应用,对癌症患者的CT检查转移灶进行分析,评价其成功率、一致性和有效性。方法两名研究者分别对患有转移癌的58例患者进行CT检查的随访,共97个目标转移灶(包括19个肺转移灶、6个肝转移灶和72个淋巴结转移灶)。测量每个转移灶的长轴或淋巴结的短轴,并用手动和病变管理应用2种方法分别给出实体瘤疗效评价标准(RECIST1.1)。检查回顾、RECIST计算和数据输入的时间分别进行记录。使用测量时间中位数来评价时间的差别,Bland-Altman分析法来评价这2种方法上研究者间的一致性。结果使用病变管理应用,肺和肝脏的病灶都可被半自动的进行分割。比较病变管理应用和手动2种方法发现,病变管理应用节省时间百分比,随访扫描研究者1为47%,研究者2为30%;初次扫描研究者1为29%,研究者2为15%。测量的差异性显示,使用病变管理应用平均差异百分比仅为7.6%,而手动测量为28.2%。结论使用病变管理应用方法相比手动的测量方法,肺和肝脏的病灶都能被成功半自动分割,两名研究者的结果一致性更高,评价肿瘤的大小更快。OBJECTIVE The purpose of this study was to evaluate the success,consistency and efficiency of a semiautomated lesion management application within a PACS in the analysis of metastatic lesions in serial CT examinations of cancer patients. METHODS Two observers using baseline and follow-up CT data independently reviewed 97 target lesions （19 lung,6 liver,72 lymph node） in 58 patients with metastatic cancer. The observers measured the longest axis （or short axis for lymph nodes） of each lesion and made Response Evaluation Criteria in Solid Tumors （RECIST） determinations using manual and lesion management application methods. The times required for examination review,RECIST cal- culations,and data input were recorded. The median time saving was used to assess time differences,and Bland-Altman a- nalysis was used to assess interobserver agreement within the manual and lesion management application methods. Percentage success rates were also reported. RESULTS With the lesion management application,most lung and liver lesions were semiautomatically segmented. Comparison of the lesion management application and manual methods for all lesions showed a median time saving of 47% for observer 1 and 30% for observer 2 on follow-up scans versus 29% for observer 1 and 15% for observer 2 on baseline scans. Variability of measurements showed mean percentage change differences of only 7.6% for the lesion management application versus 28.2% for manual measurements. CONCLUSIONS With the lesion management application method,most lung and liverlesions were successfully segmented semiautomatically. The results were more consistent between observers, and assessment of tumor size was faster than with the manual method.

关 键 词：影像归档和通信系统 计算机体层摄影术 医学图像处理 肿瘤转移 

分 类 号：R730.44[医药卫生—肿瘤]