Therapy response evaluation of malignant lymphoma in a multicenter study: comparison of manual and semiautomatic measurements in CT.
OBJECTIVE
Comparison of manual one-/bi-dimensional measurements versus semi-automatically derived one-/bi-dimensional and volumetric measurements for therapy response evaluation of malignant lymphoma during CT follow-up examinations in a multicenter setting.


METHODS
MSCT data sets of patients with malignant lymphoma were evaluated before (baseline) and after two cycles of chemotherapy (follow-up) at radiological centers of five university hospitals. The long axis diameter (LAD), the short axis diameter (SAD) and the bi-dimensional WHO of 307 target lymph nodes were measured manually and semi-automatically using dedicated software. Lymph node volumetry was performed semi-automatically only. The therapeutic response was evaluated according to lymphoma-adapted RECIST.


RESULTS
Based on a single lymph node, semi-automatically derived multidimensional parameters allowed for significantly more accurate therapy response classification than the manual or the semi-automatic unidimensional parameters. Incorrect classifications were reduced by up to 9.6%. Compared to the manual approach, the influence of the study center on correct therapy classification is significantly less relevant when using semi-automatic measurements.


CONCLUSIONS
Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients by approximately 9.6% in the multicenter setting in comparison to linear parameters. Semi-automatic quantitative software tools may help to significantly reduce wrong classifications that are associated with the manual assessment approach.


CONCLUSIONS
► Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients ► Manual lymph node evaluation with uni-dimensional parameters is inferior to semi-automatic analysis in a multicenter setting ► Semi-automatic quantitative software tools should be introduced in clinical study evaluation.
Dept. of Clinical Radiology, University of Muenster, Germany.
J
J
Weßling
Dept. of Clinical Radiology, University of Muenster, Germany.
C
C
Schülke
Dept. of Medical Informatics and Biomathematics, University of Muenster, Germany.
R
R
Koch
Dept. of Clinical Radiology, University of Muenster, Germany.
N
N
Kohlhase
Dept. of Clinical Radiology, University of Muenster, Germany.
L
L
Wassenaar
Dept. of Oncology, University of Muenster, Germany.
R
R
Mesters
Dept. of Clinical Radiology, University of Muenster, Germany.
A J
AJ
Höink
Dept. of Clinical Radiology, University of Munich, Germany.
M
M
D Anastasi
Dept. of Clinical Radiology, University of Munich, Germany.
M
M
Karpitschka
Clinic for Diagnostic Radiology, University Hospital Schleswig-Holstein Campus Kiel, Germany.
M
M
Fabel
Clinic for Diagnostic Radiology, University Hospital Schleswig-Holstein Campus Kiel, Germany.
A M
AM
Wulff
Department for Diagnostic and Interventional Radiology, University of Mainz, Germany.
D
D
Pinto dos Santos
Dept. of Diagnostic Radiology, University of Marburg, Germany.
A
A
Kiessling
Dept. of Clinical Radiology, University of Munich, Germany.
A
A
Graser
MEVIS, Fraunhofer, Bremen, Germany.
L
L
Bornemann
MEVIS, Fraunhofer, Bremen, Germany.
V
V
Dicken
Dept. of Clinical Radiology, University of Muenster, Germany.
W
W
Heindel
Dept. of Clinical Radiology, University of Muenster, Germany.
B
B
Buerke
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009367:Neoplasm Staging; D011829:Radiation Dosage; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult