- 作者列表："Jungmann F","Brodehl S","Buhl R","Mildenberger P","Schömer E","Düber C","Pinto Dos Santos D
AIM:To develop a robust open-source method for fully automated extraction of total lung capacity (TLC) from computed tomography (CT) images and to demonstrate its integration into the clinical workflow. MATERIALS AND METHODS:Using only open-source software, an algorithm was developed based on a region-growing method that does not require manual interaction. Lung volumes calculated from reconstructions with different kernels (TLCCT) were assessed. To validate the algorithm calculations, the results were correlated to TLC measured by pulmonary function testing (TLCPFT) in a subgroup of patients for which this information was available within 3 days of the CT examination. RESULTS:A total of 288 patients were analysed retrospectively. Manual review revealed poor segmentation results in 13 (4.5%) patients. In the validation subgroup, the correlation between TLCCT and TLCPFT was r=0.87 (p<0.001). Measurements showed excellent agreement between the two reconstruction kernels with an intraclass correlation coefficient (ICC) of 0.99. Calculation of the volumes took an average of 5 seconds (standard deviation: 3.72 seconds). Integration of the algorithm into the departments of the PACS environment was successful. A DICOM-encapsulated PDF document with measurements and an overlay of the segmentation results was sent to the PACS to allow the radiologists to detect false measurements. CONCLUSIONS:The algorithm developed allows fast and fully automated calculation of lung volume without any additional input from the radiologist. The algorithm delivers excellent segmentation in >95% of cases with significant positive correlations between lung volume on CT and TLC on PFT.
目的: 开发一种强大的开源方法，用于从计算机断层扫描 (CT) 图像中全自动提取肺总量 (TLC)，并将其整合到临床工作流程中。 材料和方法: 仅使用开源软件，基于不需要手动交互的区域生长方法开发了算法。评估由不同内核 (TLCCT) 的重建计算的肺体积。为了验证算法计算，将结果与在ct检查的3天内获得该信息的患者亚组中通过肺功能测试 (TLCPFT) 测量的TLC相关联。 结果: 共288例患者进行回顾性分析。人工审查显示13 (4.5%) 例患者的分割结果不佳。在验证亚组中，TLCCT和TLCPFT之间的相关性为r = 0.87 (p<0.001)。测量显示两个重建内核之间的极好的一致性，组内相关系数 (ICC) 为0.99。体积的计算平均花费5秒 (标准偏差: 3.72秒)。将算法集成到PACS环境的部门中是成功的。将具有测量结果和分割结果的叠加的DICOM封装的PDF文档发送到PACS，以允许放射科医师检测错误测量。 结论: 所开发的算法允许在没有来自放射科医师的任何额外输入的情况下快速且完全自动地计算肺体积。该算法在> 95% 的病例中提供了出色的分割，CT上的肺体积与PFT上的TLC之间具有显著的正相关。
METHODS:OBJECTIVES:The aim was to evaluate the image quality and sensitivity to artifacts of compressed sensing (CS) acceleration technique, applied to 3D or breath-hold sequences in different clinical applications from brain to knee. METHODS:CS with an acceleration from 30 to 60% and conventional MRI sequences were performed in 10 different applications in 107 patients, leading to 120 comparisons. Readers were blinded to the technique for quantitative (contrast-to-noise ratio or functional measurements for cardiac cine) and qualitative (image quality, artifacts, diagnostic findings, and preference) image analyses. RESULTS:No statistically significant difference in image quality or artifacts was found for each sequence except for the cardiac cine CS for one of both readers and for the wrist 3D proton density (PD)-weighted CS sequence which showed less motion artifacts due to the reduced acquisition time. The contrast-to-noise ratio was lower for the elbow CS sequence but not statistically different in all other applications. Diagnostic findings were similar between conventional and CS sequence for all the comparisons except for four cases where motion artifacts corrupted either the conventional or the CS sequence. CONCLUSIONS:The evaluated CS sequences are ready to be used in clinical daily practice except for the elbow application which requires a lower acceleration. The CS factor should be tuned for each organ and sequence to obtain good image quality. It leads to 30% to 60% acceleration in the applications evaluated in this study which has a significant impact on clinical workflow. KEY POINTS:• Clinical implementation of compressed sensing (CS) reduced scan times of at least 30% with only minor penalty in image quality and no change in diagnostic findings. • The CS acceleration factor has to be tuned separately for each organ and sequence to guarantee similar image quality than conventional acquisition. • At least 30% and up to 60% acceleration is feasible in specific sequences in clinical routine.
METHODS:BACKGROUND:The main surgical techniques for spontaneous basal ganglia hemorrhage include stereotactic aspiration, endoscopic aspiration, and craniotomy. However, credible evidence is still needed to validate the effect of these techniques. OBJECTIVE:To explore the long-term outcomes of the three surgical techniques in the treatment of spontaneous basal ganglia hemorrhage. METHODS:Five hundred and sixteen patients with spontaneous basal ganglia hemorrhage who received stereotactic aspiration, endoscopic aspiration, or craniotomy were reviewed retrospectively. Six-month mortality and the modified Rankin Scale score were the primary and secondary outcomes, respectively. A multivariate logistic regression model was used to assess the effects of different surgical techniques on patient outcomes. RESULTS:For the entire cohort, the 6-month mortality in the endoscopic aspiration group was significantly lower than that in the stereotactic aspiration group (odds ratio (OR) 4.280, 95% CI 2.186 to 8.380); the 6-month mortality in the endoscopic aspiration group was lower than that in the craniotomy group, but the difference was not significant (OR=1.930, 95% CI 0.835 to 4.465). A further subgroup analysis was stratified by hematoma volume. The mortality in the endoscopic aspiration group was significantly lower than in the stereotactic aspiration group in the medium (≥40-<80 mL) (OR=2.438, 95% CI 1.101 to 5.402) and large hematoma subgroup (≥80 mL) (OR=66.532, 95% CI 6.345 to 697.675). Compared with the endoscopic aspiration group, a trend towards increased mortality was observed in the large hematoma subgroup of the craniotomy group (OR=8.721, 95% CI 0.933 to 81.551). CONCLUSION:Endoscopic aspiration can decrease the 6-month mortality of spontaneous basal ganglia hemorrhage, especially in patients with a hematoma volume ≥40 mL.
METHODS:OBJECTIVE:The primary purpose of this study was to evaluate the effectiveness of a three-dimensional (3D) software tool (smart planes) for displaying fetal brain planes, and the secondary purpose was to evaluate its accuracy in performing automatic measurements. MATERIAL AND METHODS:This prospective study included singleton fetuses with a gestational age (GA) greater than 18 weeks. Transabdominal two-dimensional ultrasound (2DUS) and 3D smart planes images were respectively used to obtain the basic planes of the fetal brain, with five parameters measured. The images, by either two-dimensional (2D) manual or 3D automatic operation, were reviewed by two experienced sonographers. The agreements between two measurements were analyzed. RESULTS:A total of 226 cases were included. The rates of successful detection by automatic display were as high as 80%. There was substantial agreement between the measurements of the biparietal diameter, head circumference and transcerebellar diameter, but poor agreement between the measurements of cisterna magna and lateral ventricle width. CONCLUSIONS:Smart Planes might be valuable for the rapid evaluation of fetal brain, because it simplifies the evaluation process. However, the technology requires improvement. In addition, this technology cannot replace the conventional manual US scans; it can only be used as an additional approach.