Variability of HCC Tumor Diameter and Density Measurements on Dynamic Contrast-Enhanced Computed Tomography.

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Tomography Pub Date : 2025-03-19 DOI:10.3390/tomography11030036

Siddharth Guha, Abdalla Ibrahim, Pengfei Geng, Qian Wu, Yen Chou, Oguz Akin, Lawrence H Schwartz, Chuan-Miao Xie, Binsheng Zhao

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引用次数: 0

Abstract

Purpose: In cancers imaged using contrast-enhanced protocols, such as hepatocellular carcinoma (HCC), formal guidelines rely on measurements of lesion size (in mm) and radiographic density (in Hounsfield units [HU]) to evaluate response to treatment. However, the variability of these measurements across different contrast enhancement phases remains poorly understood. This limits the ability of clinicians to discern whether measurement changes are accurate.

Methods: In this study, we investigated the variability of maximal lesion diameter and mean lesion density of HCC lesions on CT scans across four different contrast enhancement phases: non-contrast-enhanced phase (NCE), early arterial phase (E-AP), late arterial phase (L-AP), and portal venous phase (PVP). HCC lesions were independently segmented by two expert radiologists. For each pair of a lesion's scan timepoints, one was selected randomly as the baseline measurement and the other as the repeat measurement. Both absolute and relative differences in measurements were calculated, as were the coefficients of variance (CVs). Analysis was further stratified by both contrast enhancement phase and lesion diameter.

Results: Lesion diameter was found to have a CV of 5.11% (95% CI: 4.20-6.01%). About a fifth of the measurement's relative changes were greater than 10%. Although there was no significant difference in diameter measurements across different phases, there was a significant negative correlation (R = -0.303, p-value = 0.030) between lesion diameter and percent difference in diameter measurement. Lesion density measurements varied significantly across all phases, with the greatest relative difference of 47% in the late arterial phase and a CV of 22.84% (21.48-24.20%). The overall CV for lesion density measurements was 26.19% (24.66-27.72%).

Conclusions: Changes in tumor diameter measurements within 10% may simply be due to variability, and lesion density is highly sensitive to contrast timing. This highlights the importance of paying attention to these two variables when evaluating tumor response in both clinical trials and practice.

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动态增强计算机断层扫描对HCC肿瘤直径和密度测量的可变性。

目的：在使用对比增强方案成像的癌症中，如肝细胞癌（HCC），正式指南依赖于病变大小（毫米）和放射密度（Hounsfield单位[HU]）的测量来评估对治疗的反应。然而，这些测量的可变性在不同的对比度增强阶段仍然知之甚少。这限制了临床医生辨别测量变化是否准确的能力。方法：在本研究中，我们研究了HCC病变在四个不同增强期(非增强期（NCE）、早期动脉期（E-AP）、晚期动脉期（L-AP）和门静脉期（PVP）的CT扫描上最大病变直径和平均病变密度的变异性。HCC病变由两名放射专家独立分割。对于每一对病变的扫描时间点，随机选择一个作为基线测量，另一个作为重复测量。计算测量的绝对和相对差异，以及方差系数（cv）。根据增强阶段和病变直径进一步分层分析。结果：病变直径的CV为5.11% （95% CI: 4.20-6.01%）。大约五分之一的测量相对变化大于10%。虽然不同阶段的直径测量值无显著差异，但病变直径与直径测量值差异百分比之间存在显著负相关（R = -0.303， p值= 0.030）。各期病变密度测量差异显著，动脉晚期相对差异最大，为47%，CV为22.84%（21.48-24.20%）。病变密度测量的总CV为26.19%（24.66-27.72%）。结论：肿瘤直径测量值在10%以内的变化可能仅仅是由于变异性，而病变密度对对比时间高度敏感。这突出了在临床试验和实践中评估肿瘤反应时注意这两个变量的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Tomography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

2.70

自引率

10.50%

发文量

222

期刊介绍： TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.