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首页> 外文期刊>Acta Radiologica >Measurement of response of pulmonal tumors in 64-slice MDCT.
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Measurement of response of pulmonal tumors in 64-slice MDCT.

机译：在64层MDCT中测量肺部肿瘤的反应。

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BACKGROUND: Advances in CT technology from single to multi-detector row CT (MDCT) permit a high resolution and volumetric presentation of pulmonary lesions. This implicates emerging measurement techniques that need to be contrasted with established methods. PURPOSE: To compare bidimensional, unidimensional, and volumetric methods for evaluation of treatment response in patients with lung lesions. MATERIAL AND METHODS: This study comprised 68 patients with pulmonary lesions who underwent a total of 276 64-MDCTs of chest at baseline and follow-up. RECIST and WHO criteria were used for unidimensional and bidimensional methods and region growing (RG) for volumetry. Patients were classified into four response categories. Respectively, two measurement techniques were contrasted and the kappa index was calculated. For intra-observer reproducibility the relative measurement error (RME) and kappa index with regard to agreement of response categories were evaluated. RESULTS: Comparison of WHO und RECIST criteria achieves high correlation with kappa indices of 0.76 and 0.82. In particular, lesions with moderate increase of size in the range of 25-44% for bidimensional and 12-29% for unidimensional measurement result in different response categories when applying WHO and RECIST criteria. WHO criteria delivered PD more often than RECIST. kappa indices of 0.79 and 0.87 were attained in comparison of RECIST and RG, and 0.83 and 0.84 for WHO and RG. RME was 2.82% for RECIST, 7.53% for WHO, and 8.97% for RG. Intra-observer reproducibility was 95% for RECIST, 95% for WHO, and 96% for RG. CONCLUSION: The comparison of all methods resulted in no statistically significant differences. WHO criteria seemed to diverge the most, they declared several lesions prematurely as progression, and showed no benefit in comparison to RECIST. RG showed the best reproducibility, considered irregular lesions, was slightly superior to RECIST, and could be applied uniformly. Unidimensional measurement represents an adequate alternative with the advantage of better clinical work flow.
机译：背景：CT技术从单排CT到多排CT（MDCT）的进步允许对肺部病变进行高分辨率和容积表现。这意味着新兴的测量技术需要与已建立的方法进行对比。目的：比较二维，一维和容积法评估肺部病变患者的治疗反应。材料与方法：这项研究包括68例肺部病变患者，他们在基线和随访期间共进行了276次胸部64-MDCT检查。 RECIST和WHO标准用于一维和二维方法，而区域生长（RG）用于容积法。将患者分为四个反应类别。分别比较了两种测量技术并计算了kappa指数。对于观察者内部可再现性，评估了相对于反应类别一致性的相对测量误差（RME）和kappa指数。结果：WHO和RECIST标准的比较与kappa指数为0.76和0.82高度相关。特别是，在采用WHO和RECIST标准时，尺寸在二维范围内适度增加的病变在25-44％范围内，一维尺寸范围在12-29％的范围内导致不同的响应类别。 WHO标准提供的PD数据比RECIST更多。与RECIST和RG相比，kappa指数分别为0.79和0.87，而WHO和RG的kappa指数分别为0.83和0.84。 RECIST的RME为2.82％，WHO为7.53％，RG为8.97％。 RECIST的观察者内部可重复性为95％，WHO为95％，RG为96％。结论：所有方法的比较均无统计学差异。 WHO的标准似乎分歧最大，他们宣布疾病进展为过早，与RECIST相比没有任何益处。 RG显示出最佳的可重复性，被认为是不规则的病灶，略优于RECIST，可以统一使用。一维测量是一种更好的替代方法，具有更好的临床工作流程的优势。

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