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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 To evaluate the success, consistency and effectiveness of CT-based metastatic cancer screening in cancer patients using semi-automatic lesion management in image archiving and communication systems (PACS). METHODS: Two investigators performed a CT scan of 58 patients with metastatic cancer, respectively, for a total of 97 target metastases (including 19 lung metastases, 6 liver metastases and 72 lymph node metastases). The long axis of each metastasis or the short axis of the lymph nodes was measured and two methods of manual and lesion management were used to evaluate the efficacy of the solid tumor evaluation criteria (RECIST1.1). Check the recall, RECIST calculation and data entry time were recorded. Median measurement time was used to assess differences in time and Bland-Altman analysis was used to evaluate the agreement between the two methods. Results Using a lesion management application, both lung and liver lesions can be segmented semi-automatically. Comparison of pathological management applications and manual methods found that the percentage of time spent on pathological management savings was 47% for follow-up scanners, 30% for investigator 2, 29% for initial scan 1, and 15% for investigator 2. The differences in the measurements showed that the average percentage difference in the use of the disease management application was only 7.6% compared to 28.2% for the manual measurement. CONCLUSIONS: Compared with manual methods of measurement, the lesions of lung and liver can be successfully semi-automatically segmented using the method of pathological management. The findings of the two investigators are more consistent and the tumor size is estimated to be faster.