RECIST and WHO criteria evaluation of cervical, thoracic and abdominal lymph nodes in patients with malignant lymphoma: manual versus semi-automated measurement on standard MDCT slices.
OBJECTIVE
Since semi-automated lesion quantification may be more precise than manual uni- and bidimensional measurements, the purpose of this study was to compare semi-automated with manual evaluations of cervical, thoracic and abdominal lymph nodes in patients with malignant lymphoma.


METHODS
62 patients with known malignant lymphoma underwent staging with contrast-enhanced 16-MDCT (16x0.7 mm coll., 120 kV, cervical/thoracic/abdominal: 150/120/160 mAseff., 1/1.25 /1 pitch, 4/3 - 5/4 - 5/4 slice thickness/reconstruction increment). On the basis of these standard reconstructed slices, each lesion was quantified in terms of RECIST and its longest orthographic diameter using a semi-automated software tool (Syngo CT Oncology, Siemens Medical Solutions, Forchheim, Germany) and manually by an experienced radiologist. The degree of agreement between manual measurements and software quantification was statistically assessed by computing the concordance correlation coefficient kappa and represented graphically in corresponding Bland-Altman plots.


RESULTS
74/80 cervical, 51/80 thoracic and 75/80 abdominal lymph nodes were correctly evaluated by the software. A strong degree of agreement between both measurement techniques (RECIST diameter: kappa = 0.97 (cervical)/0.98 (thoracic)/0.99 (abdominal); longest orthographic diameter: kappa = 0.97/0.93/0.97) was obtained.


CONCLUSIONS
Semi-automated measurement of cervical, thoracic and abdominal lymph nodes showed valid results on standard axial reconstructions compared to manual quantification with the limitation of a high false segmentation rate in thoracic lymph nodes.
Keil
S
S
Klinik für Radiologische Diagnostik, Universitätsklinikum RWTH Aachen. keil@rad.rwth-aachen.de
Behrendt
F F
FF
Stanzel
S
S
Suehling
M
M
Jost
E
E
Mühlenbruch
G
G
Mahnken
A
A
Günther
R W
RW
Das
M
M
D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001185:Artificial Intelligence; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods* / Q000592:standards; D008220:Lymphography / Q000379:methods* / Q000592:standards; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods* / Q000592:standards; D011873:Radiology Information Systems; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012984:Software; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging*; D036542:Tomography, Spiral Computed / Q000379:methods* / Q000592:standards; D051598:Whole Body Imaging / Q000379:methods* / Q000592:standards; D014944:World Health Organization
D003287:Contrast Media