Computed tomography volumetry of esophageal cancer - the role of semiautomatic assessment

Yi-Hua Zhang,Henrik Lehmann,Torkel B Brismar,Ioannis Rouvelas,Michael A Fischer,Lars Lundell,Åse Johnsson,Gunnar Herlin

doi:10.1186/s12880-019-0317-5

Abstract

BackgroundThe clinical and research value of Computed Tomography (CT) volumetry of esophageal cancer tumor size remains controversial. Development in CT technique and image analysis has made CT volumetry less cumbersome and it has gained renewed attention. The aim of this study was to assess esophageal tumor volume by semi-automatic measurements as compared to manual.MethodsA total of 23 esophageal cancer patients (median age 65, range 51–71), undergoing CT in the portal-venous phase for tumor staging, were retrospectively included between 2007 and 2012. One radiology resident and one consultant radiologist measured the tumor volume by semiautomatic segmentation and manual segmentation. Reproducibility of the respective measurements was assessed by intraclass correlation coefficients (ICC) and by average deviation from mean.ResultsMean tumor volume was 46 ml (range 5-137 ml) using manual segmentation and 42 ml (range 3-111 ml) using semiautomatic segmentation. Semiautomatic measurement provided better inter-observer agreement than traditional manual segmentation. The ICC was significantly higher for semiautomatic segmentation in comparison to manual segmentation (0.86, 0.56, p < 0.01). The average absolute percentage difference from mean was reduced from 24 to 14% (p < 0.001) when using semiautomatic segmentation.ConclusionsSemiautomatic analysis outperforms manual analysis for assessment of esophageal tumor volume, improving reproducibility.

Highlights

The clinical and research value of Computed Tomography (CT) volumetry of esophageal cancer tumor size remains controversial
The intraclass correlation coefficients (ICC) was significantly higher for semiautomatic segmentation in comparison to manual segmentation (0.86, 0.56, p < 0.01)
No significant differences in volume were observed between adenocarcinoma and squamous cell carcinoma

Summary

Introduction

The clinical and research value of Computed Tomography (CT) volumetry of esophageal cancer tumor size remains controversial. At the time of diagnosis, patients with carcinoma of the esophagus often have a locally advanced disease stage with or without distant metastasis [1]. Intervention and Technology, Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden. Depending on a variety of factors, the obstruction to the passage of food, through the expanding and stricturing tumor area, results in clinically overt symptoms first at a relatively advanced local stage of the disease [7]. In the evaluation of these patients, accurate staging is mandatory and hereby endoscopic ultrasonography, computed tomography (CT) and positron emission tomography (PET) with fluorine 18 fluorodeoxyglucose (FDG) have taken a central role.

Objectives

Methods

Results

Discussion

Conclusion