Tumor Burden in Patients with Neurofibromatosis Types 1 and 2 and Schwannomatosis: Determination on Whole-Body MR Images

被引:83
作者
Cai, Wenli [1 ]
Kassarjian, Ara [1 ]
Bredella, Miriam A. [1 ]
Harris, Gordon J. [1 ]
Yoshida, Hiroyuki [1 ]
Mautner, Victor F. [3 ]
Wenzel, Ralph [3 ]
Plotkin, Scott R. [2 ]
机构
[1] Massachusetts Gen Hosp, Dept Radiol, Boston, MA 02114 USA
[2] Massachusetts Gen Hosp, Dept Neurol, Boston, MA 02114 USA
[3] Univ Hamburg Hosp, Dept Neurol, D-2000 Hamburg, Germany
关键词
PHASE-I TRIAL; PLEXIFORM NEUROFIBROMAS; INTRAOBSERVER VARIABILITY; VOLUME MEASUREMENT; SOLID TUMORS; LUNG LESIONS; INTEROBSERVER; CT; REPRODUCIBILITY; MANAGEMENT;
D O I
10.1148/radiol.2503080700
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: To develop a three-dimensional (3D) segmentation and computerized volumetry technique for use in the assessment of neurofibromatosis and to assess the ability of this technique to aid in the calculation of tumor burden in patients with neurofibromatosis types 1 and 2 (NF1 and NF2, respectively) and schwannomatosis detected with whole-body magnetic resonance (MR) imaging. Materials and Methods: Institutional review board approval and written informed consent were obtained for this prospective HIPAA-compliant study. Fifty-two subjects (27 women, 25 men; mean age, 42 years +/- 15 [standard deviation]; age range, 24-86 years) underwent whole-body MR imaging performed with coronal short inversion time inversion-recovery (STIR) sequences. Whole-body tumor burden was estimated with a 3D segmentation method (the dynamic-threshold [DT] level set method) in 29 subjects (16 with NF1, six with NF2, and seven with schwannomatosis) in whom at least one nerve sheath tumor was reliably identified on MR images. Fifty tumors (25 plexiform and 25 discrete tumors) were randomly selected and subjected to manual and computerized volumetry to assess reliability. Ten plexiform tumors 5 cm or larger in diameter were retrospectively selected and segmented with three initialization methods for computerized volumetry and manually contoured by three radiologists to assess repeatability. Bland-Altman analysis was performed, and intraclass correlation coefficients (ICCs) were calculated. Results: A total of 398 nerve sheath tumors (185 plexiform and 213 discrete tumors) were identified in 29 subjects. Volumetric measurements obtained with the computerized method and manual contouring were highly correlated (r(ICC) = 0.99). Bland-Altman analysis showed that computerized volumetry had a mean difference of -2.6% compared with manual volumetry. The repeatability coefficient of the computerized scheme was +/- 5% compared with +/- 30% for manual contouring. Conclusion: This 3D segmentation and computerized volumetry technique is reliable relative to manual segmentation and has the advantage of being less labor intensive and more repeatable. This technique can be paired with whole-body MR imaging to determine tumor burden in patients with neurofibromatosis. (c) RSNA, 2009
引用
收藏
页码:665 / 673
页数:9
相关论文
共 25 条
[1]  
[Anonymous], 1979, WHO OFFS PUBL
[2]  
[Anonymous], 2006, Digital Image Processing
[3]   Phase I trial of pirfenidone in children with neurofibromatosis 1 and plexiform neurofibromas [J].
Babovic-Vuksanovic, Dusica ;
Widemann, Brigitte C. ;
Dombi, Eva ;
Gillespie, Andrea ;
Wolters, Pamela L. ;
Toledo-Tamula, Mary Anne ;
O'Neill, Brian P. ;
Fox, Elizabeth ;
MacDonald, Tobey ;
Beck, Heather ;
Packer, Roger J. .
PEDIATRIC NEUROLOGY, 2007, 36 (05) :293-300
[4]   Measuring agreement in method comparison studies [J].
Bland, JM ;
Altman, DG .
STATISTICAL METHODS IN MEDICAL RESEARCH, 1999, 8 (02) :135-160
[5]   STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT [J].
BLAND, JM ;
ALTMAN, DG .
LANCET, 1986, 1 (8476) :307-310
[6]   Dynamic-threshold level set method for volumetry of porcine kidney in CT images: In vivo and ex vivo assessment of the accuracy of volume measurement [J].
Cai, Wenli ;
Holalkere, Nagaraj-Setty ;
Harris, Gordon ;
Sahani, Dushyant ;
Yoshida, Hiroyuki .
ACADEMIC RADIOLOGY, 2007, 14 (07) :890-896
[7]  
Dempsey MF, 2005, AM J NEURORADIOL, V26, P770
[8]   NF1 plexiform neurofibroma growth rate by volumetric MRI - Relationship to age and body weight [J].
Dombi, E. ;
Solomon, J. ;
Gillespie, A. J. ;
Fox, E. ;
Balis, F. M. ;
Patronas, N. ;
Korf, B. R. ;
Babovic-Vuksanovic, D. ;
Packer, R. J. ;
Belasco, J. ;
Goldman, S. ;
Jakacki, R. ;
Kieran, M. ;
Steinberg, S. M. ;
Widemann, B. C. .
NEUROLOGY, 2007, 68 (09) :643-647
[9]   Interobserver and intraobserver variability in measurement of non-small-cell carcinoma lung lesions: Implications for assessment of tumor response [J].
Erasmus, JJ ;
Gladish, GW ;
Broemeling, L ;
Sabloff, BS ;
Truong, MT ;
Herbst, RS ;
Munden, RF .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (13) :2574-2582
[10]   Phase I study of thalidomide for the treatment of plexiform neurofibroma in neurofibromatosis 1 [J].
Gupta, A ;
Cohen, BH ;
Ruggieri, P ;
Packer, RJ ;
Phillips, PC .
NEUROLOGY, 2003, 60 (01) :130-132