title: Computing quantitative indicators of structural renal damage in pediatric DMSA scans.
abstract: OBJECTIVE
  The proposal and implementation of a computational framework for the quantification of structural renal damage from99mTc-dimercaptosuccinic acid (DMSA) scans. The aim of this work is to propose, implement, and validate a computational framework for the quantification of structural renal damage from DMSA scans and in an observer-independent manner.
  
  
  METHODS
  From a set of 16 pediatric DMSA-positive scans and 16 matched controls and using both expert-guided and automatic approaches, a set of image-derived quantitative indicators was computed based on the relative size, intensity and histogram distribution of the lesion. A correlation analysis was conducted in order to investigate the association of these indicators with other clinical data of interest in this scenario, including C-reactive protein (CRP), white cell count, vesicoureteral reflux, fever, relative perfusion, and the presence of renal sequelae in a 6-month follow-up DMSA scan.
  
  
  RESULTS
  A fully automatic lesion detection and segmentation system was able to successfully classify DMSA-positive from negative scans (AUC=0.92, sensitivity=81% and specificity=94%). The image-computed relative size of the lesion correlated with the presence of fever and CRP levels (p<0.05), and a measurement derived from the distribution histogram of the lesion obtained significant performance results in the detection of permanent renal damage (AUC=0.86, sensitivity=100% and specificity=75%).
  
  
  CONCLUSIONS
  The proposal and implementation of a computational framework for the quantification of structural renal damage from DMSA scans showed a promising potential to complement visual diagnosis and non-imaging indicators.
authors.affiliation: Autonomous University of Barcelona, Faculty of Medicine, 08193 Barcelona, Spain. Electronic address: fredsampedro@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Sampedro
authors.affiliation: Hospital de Sant Pau, Nuclear Medicine Department, Carrer Sant Quintí 89, 08026 Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Domenech
authors.affiliation: Computer Vision Center, Campus UAB, Edifici O, 08193 Bellaterra, Barcelona, Spain; Department of Applied Mathematics and Analysis, Universitat de Barcelona, Gran Via de les Corts 585, 08007 Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Escalera
authors.affiliation: Hospital de Sant Pau, Nuclear Medicine Department, Carrer Sant Quintí 89, 08026 Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Carrio
mesh_terms: D000465:Algorithms; D019540:Area Under Curve; D001331:Automation; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D015588:Observer Variation; D049268:Positron-Emission Tomography; D012372:ROC Curve; D019275:Radiopharmaceuticals / Q000032:analysis*; D012680:Sensitivity and Specificity; D019783:Technetium Tc 99m Dimercaptosuccinic Acid / Q000032:analysis*
chemical_list: D015415:Biomarkers; D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D002097:C-Reactive Protein
keywords: Análisis cuantitativo; Análisis de imagen; DMSA; DMSA scan; Daño renal; Image processing; Quantitative analysis; Renal damage