Therapy response evaluation of malignant lymphoma in a multicenter study: comparison of manual and semiautomatic measurements in CT

PURPOSE

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.

MATERIALS AND 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.

CONCLUSION

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.

KEY POINTS

► 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.

Variation in shell chemistry of terrestrial gastropods (Cerion incanum, Cerion uva, and Tudora maculata) from the Florida Keys and Bonaire

Cerion and Tudora from the Florida Keys and Bonaire secrete shells composed of prismatic, homogeneous, and crossed-lamellar aragonitic layers. Strontium, magnesium, and sodium contents of shells of Cerion from Sugarloaf Key are greatly influenced by the marine waters that regularly inundate this island. In contrast, the concentrations of these elements in shells in Cerion from Windley Key are controlled by both freshwater, in the form of precipitation, and seawater seeping through the rock into the quarry. Strontium and, to a lesser degree, magnesium are deficient and sodium is relatively high in shells of Cerion and Tudora from dried-out ponds on Bonaire. As with the other elements, concentrations of iron, manganese, and nickel in the shells of the studied gastropods are also controlled by the type and amount of water present in each local environment.