Rofo 2014; 186(08): 768-779
DOI: 10.1055/s-0033-1356424
Abdomen
© Georg Thieme Verlag KG Stuttgart · New York

Therapy Response Evaluation of Malignant Lymphoma in a Multicenter Study: Comparison of Manual and Semiautomatic Measurements in CT

Beurteilung des Therapieansprechens beim Malignen Lymphom: Multizentrischer Vergleich von manuellen und semiautomatischen Messungen im CT
J. Weßling
1   Dept. of Clinical Radiology, University of Muenster, Germany
,
C. Schülke
1   Dept. of Clinical Radiology, University of Muenster, Germany
,
R. Koch
2   Dept. of Medical Informatics and Biomathematics, University of Muenster, Germany
,
N. Kohlhase
1   Dept. of Clinical Radiology, University of Muenster, Germany
,
L. Wassenaar
1   Dept. of Clinical Radiology, University of Muenster, Germany
,
R. Mesters
3   Dept. of Oncology, University of Muenster, Germany
,
A. J. Höink
1   Dept. of Clinical Radiology, University of Muenster, Germany
,
M. D´Anastasi
4   Dept. of Clinical Radiology, University of Munich, Germany
,
M. Karpitschka
4   Dept. of Clinical Radiology, University of Munich, Germany
,
M. Fabel
5   Clinic for Diagnostic Radiology, University Hospital Schleswig-Holstein Campus Kiel, Germany
,
A. M. Wulff
5   Clinic for Diagnostic Radiology, University Hospital Schleswig-Holstein Campus Kiel, Germany
,
D. Pinto dos Santos
7   Department for Diagnostic and Interventional Radiology, University of Mainz, Germany
,
A. Kiessling
8   Dept. of Diagnostic Radiology, University of Marburg, Germany
,
A. Graser
4   Dept. of Clinical Radiology, University of Munich, Germany
,
L. Bornemann
9   MEVIS, Fraunhofer, Bremen, Germany
,
V. Dicken
9   MEVIS, Fraunhofer, Bremen, Germany
,
W. Heindel
1   Dept. of Clinical Radiology, University of Muenster, Germany
,
B. Buerke
1   Dept. of Clinical Radiology, University of Muenster, Germany
› Author Affiliations
Further Information

Publication History

25 June 2013

10 December 2013

Publication Date:
04 February 2014 (online)

Abstract

Purpose: Comparison of manual one-/bi-dimensional measurements versus semi-automatically derived one-/bi-dimensional and volumetric measurements for therapy response evaluation of malignant lymphoma during CT follow-up examinations in a multicenter setting.

Materials and Methods: MSCT data sets of patients with malignant lymphoma were evaluated before (baseline) and after two cycles of chemotherapy (follow-up) at radiological centers of five university hospitals. The long axis diameter (LAD), the short axis diameter (SAD) and the bi-dimensional WHO of 307 target lymph nodes were measured manually and semi-automatically using dedicated software. Lymph node volumetry was performed semi-automatically only. The therapeutic response was evaluated according to lymphoma-adapted RECIST.

Results: Based on a single lymph node, semi-automatically derived multidimensional parameters allowed for significantly more accurate therapy response classification than the manual or the semi-automatic unidimensional parameters. Incorrect classifications were reduced by up to 9.6 %. Compared to the manual approach, the influence of the study center on correct therapy classification is significantly less relevant when using semi-automatic measurements.

Conclusion: Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients by approximately 9.6 % in the multicenter setting in comparison to linear parameters. Semi-automatic quantitative software tools may help to significantly reduce wrong classifications that are associated with the manual assessment approach.

Key Points:

• Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients

• Manual lymph node evaluation with uni-dimensional parameters is inferior to semi-automatic analysis in a multicenter setting

• Semi-automatic quantitative software tools should be introduced in clinical study evaluation.

Citation Format:

• Weßling J, Schülke C, Koch R et al. Therapy Response Evaluation of Malignant Lymphoma in a Multicenter Study: Comparison of Manual and Semiautomatic Measurements in CT. Fortschr Röntgenstr 2014; 186: 768 – 779

Zusammenfassung

Ziel: Multizentrischer Vergleich von manuellen ein-/bi-dimensionalen Messungen und semi-automatischen ein-/bi-dimensionalen und volumetrischen Messungen zur Beurteilung des Therapieansprechens beim Malignen Lymphopm in CT-Verlaufskontrollen.

Material und Methoden: MSCT-Datensätze von Patienten mit Malignem Lymphom wurden vor (baseline) und nach zwei Zyklen Chemotherapie (follow-up) in fünf Universitätsradiologien ausgewertet. Der Langachsen- (LAD), der Kurzachsendurchmesser (SAD) und die bi-dimensionale WHO-Fläche von 307 Target-Lymphknoten wurden manuell und semi-automatisch unter Verwendung einer dedizierten Software bestimmt. Die Lymphknotenvolumetrie wurde lediglich semi-automatisch bestimmt. Das Therapieansprechen wurde anhand Lymphom-adaptierter RECIST-Kriterien beurteilt.

Ergebnisse: Auf der Basis des einzelnen Lymphknotens wiesen semi-automatisch bestimmte mehrdimensionale Parameter einen höheren Anteil in der korrekten Beurteilung des Therapieansprechens als die die manuell oder semi-automatisch bestimmten eindimensionalen Parameter auf. Fehlklassifikationen wurden um bis 9,6 % reduziert. Zusätzlich war im Vergleich zu den manuellen Messungen der Einfluss auf die Beurteilung des Therapieansprechens in den einzelnen Studienzentren bei Anwendung semi-automatischer Messungen geringer.

Schlussfolgerung: Die semi-automatische Volumetrie und die bi-dimensionale WHO-Messung reduzieren die Anzahl von Fehlklassifikationen in der Beurteilung des Therapieansprechens bei Patienten mit Malignem Lymphom signifikant um 9,6 % in einem Multicenterumfeld im Vergleich zu linearen Parametern. Semi-automatische Software-Tools können dazu beitragen, Fehlklassifikationen manueller Messungen zu reduzieren und sollten daher insbesondere in klinischen Studien zukünftig aber auch in die klinische Routine implementiert werden.

Kernaussagen:

• Semi-automatisches Volumen und bi-dimensionaler WHO-Messungen reduzieren die Anzahl von Fehlklassifikationen beim Therapieansprechen signifikant (p < 0,05)

• Die manuelle Auswertung von Lymphknoten auf Basis uni-dimensionaler Parameter ist der semi-automatischen in einem Multicenter-Setting unterlegen

• Semi-automatische quantitative Softwaretools sollten zur Auswertung in klinischen Studien obligat eingesetzt und zukünftig auch in der klinischen Routine implementiert werden.

 
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