Dataset Information

Comparison of a novel algorithm quantitatively estimating epifascial fibrosis in three-dimensional computed tomography images to other clinical lymphedema grading methods.

ABSTRACT: No method has yet been approved for detecting lymphedema fibrosis before its progression. This study assessed the feasibility of computed tomography-based estimation of fibrosis. This observational, cross-sectional study included patients with lymphedema affecting one limb. Three types (maximum, mean, minimum) of computed tomography reticulation indexes were digitally calculated from trans-axial images using absorptive values, and the computed tomography reticulation indexes compared with clinical scales and measurements. Of 326 patients evaluated by at least one of lymphoscintigraphy, bio-electrical impedance, and computed tomography, 24 were evaluated by all three. The mean number of computed tomography scans in these patients was 109. Sixteen patients had breast cancer, seven had gynecologic cancers, and one had primary lymphedema. Mean computed tomography reticulation index (r = 0.52, p < 0.01) and maximal computed tomography reticulation index (r = 0.45, p < 0.05) were significantly associated with time from initial limb swelling to computed tomography. Mean computed tomography reticulation index (r = 0.86, p < 0.01), minimal computed tomography reticulation index (r = 0.79, p < 0.01), and maximal computed tomography reticulation index (r = 0.68, p < 0.01) were significantly associated with International Society of Lymphedema substage. Minimal computed tomography reticulation index correlated with 1-kHz-based bio-electrical impedance ratio (r = -0.46, p < 0.05) and with standardized proximal limb circumference difference ratio (r = 0.45, p < 0.05) of both limbs. Maximal computed tomography reticulation index had a sensitivity of 0.78, specificity of 0.60, and areas under the curve of 0.66 in detecting lymphoscintigraphic stage IV. The algorithm utilizing three-dimensional computed tomography images of epifascial fibrosis may be used as a marker for lymphedema duration, limb swelling, International Society of Lymphedema substage, and interstitial lymphatic fluids of lymphedema. The current approach shows promise in providing an additional method to assist in characterizing and monitoring lymphedema patients.

SUBMITTER: Koo KI

PROVIDER: S-EPMC6903723 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Comparison of a novel algorithm quantitatively estimating epifascial fibrosis in three-dimensional computed tomography images to other clinical lymphedema grading methods.

Koo Kyo-In KI Ko Myoung-Hwan MH Lee Yongkwan Y Son Hye Won HW Lee Suwon S Hwang Chang Ho CH

PloS one 20191210 12

No method has yet been approved for detecting lymphedema fibrosis before its progression. This study assessed the feasibility of computed tomography-based estimation of fibrosis. This observational, cross-sectional study included patients with lymphedema affecting one limb. Three types (maximum, mean, minimum) of computed tomography reticulation indexes were digitally calculated from trans-axial images using absorptive values, and the computed tomography reticulation indexes compared with clinic ...[more]

PMID: 31821335

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Project description:Study designRetrospective diagnostic study.ObjectiveTo automatically detect osteolytic bone metastasis lesions in the thoracolumbar region using conventional computed tomography (CT) scans, we developed a new deep learning (DL)-based computer-aided detection model.Summary of background dataRadiographic detection of bone metastasis is often difficult, even for orthopedic surgeons and diagnostic radiologists, with a consequent risk for pathologic fracture or spinal cord injury. If we can improve detection rates, we will be able to prevent the deterioration of patients' quality of life at the end stage of cancer.Materials and methodsThis study included CT scans acquired at Tokyo Medical and Dental University (TMDU) Hospital between 2016 and 2022. A total of 263 positive CT scans that included at least one osteolytic bone metastasis lesion in the thoracolumbar spine and 172 negative CT scans without bone metastasis were collected for the datasets to train and validate the DL algorithm. As a test data set, 20 positive and 20 negative CT scans were separately collected from the training and validation datasets. To evaluate the performance of the established artificial intelligence (AI) model, sensitivity, precision, F1-score, and specificity were calculated. The clinical utility of our AI model was also evaluated through observer studies involving six orthopaedic surgeons and six radiologists.ResultsOur AI model showed a sensitivity, precision, and F1-score of 0.78, 0.68, and 0.72 (per slice) and 0.75, 0.36, and 0.48 (per lesion), respectively. The observer studies revealed that our AI model had comparable sensitivity to orthopaedic or radiology experts and improved the sensitivity and F1-score of residents.ConclusionWe developed a novel DL-based AI model for detecting osteolytic bone metastases in the thoracolumbar spine. Although further improvement in accuracy is needed, the current AI model may be applied to current clinical practice.Level of evidenceLevel III.

Project description:Purpose4-dimensional computed tomography (4D-CT)-based pulmonary ventilation imaging is an emerging functional imaging modality. The purpose of this study was to investigate the physiological significance of 4D-CT ventilation imaging by comparison with pulmonary function test (PFT) measurements and single-photon emission CT (SPECT) ventilation images, which are the clinical references for global and regional lung function, respectively.Methods and materialsIn an institutional review board-approved prospective clinical trial, 4D-CT imaging and PFT and/or SPECT ventilation imaging were performed in thoracic cancer patients. Regional ventilation (V4DCT) was calculated by deformable image registration of 4D-CT images and quantitative analysis for regional volume change. V4DCT defect parameters were compared with the PFT measurements (forced expiratory volume in 1 second (FEV1; % predicted) and FEV1/forced vital capacity (FVC; %). V4DCT was also compared with SPECT ventilation (VSPECT) to (1) test whether V4DCT in VSPECT defect regions is significantly lower than in nondefect regions by using the 2-tailed t test; (2) to quantify the spatial overlap between V4DCT and VSPECT defect regions with Dice similarity coefficient (DSC); and (3) to test ventral-to-dorsal gradients by using the 2-tailed t test.ResultsOf 21 patients enrolled in the study, 18 patients for whom 4D-CT and either PFT or SPECT were acquired were included in the analysis. V4DCT defect parameters were found to have significant, moderate correlations with PFT measurements. For example, V4DCT(HU) defect volume increased significantly with decreasing FEV1/FVC (R=-0.65, P<.01). V4DCT in VSPECT defect regions was significantly lower than in nondefect regions (mean V4DCT(HU) 0.049 vs 0.076, P<.01). The average DSCs for the spatial overlap with SPECT ventilation defect regions were only moderate (V4DCT(HU)0.39 ± 0.11). Furthermore, ventral-to-dorsal gradients of V4DCT were strong (V4DCT(HU) R(2) = 0.69, P=.08), which was similar to VSPECT (R(2) = 0.96, P<.01).ConclusionsAn 18-patient study demonstrated significant correlations between 4D-CT ventilation and PFT measurements as well as SPECT ventilation, providing evidence toward the validation of 4D-CT ventilation imaging.

Dataset Information

Comparison of a novel algorithm quantitatively estimating epifascial fibrosis in three-dimensional computed tomography images to other clinical lymphedema grading methods.

Publications

Comparison of a novel algorithm quantitatively estimating epifascial fibrosis in three-dimensional computed tomography images to other clinical lymphedema grading methods.

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