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A New Metric for Detecting Change in Slowly Evolving Brain Tumors: Validation in Meningioma Patients

1Section of Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.
2Microsoft Research Cambridge, Cambridge, UK.
3Asclepios Research Project, INRIA, Sophia Antipolis, France.
4Surgical Planning Lab, Department of Radiology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA.
5Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.
Lippincott Williams & Wilkins
Publication Date:
Volume Number:
Issue Number:
1 Suppl Operative
Neurosurgery. 2011 Mar;68(1 Suppl Operative):225-33.
PubMed ID:
Automatic Change Detection, Meningioma, Growth Rate, Time Series Analysis, Statistical Modeling, Longitudinal Studies, Slowly Evolving Pathologies
Appears in Collections:
P41 RR013218/RR/NCRR NIH HHS/United States
U54 EB005149/EB/NIBIB NIH HHS/United States
P41 RR019703/RR/NCRR NIH HHS/United States
Generated Citation:
Pohl K.M., Konukoglu E., Novellas S., Ayache N., Fedorov A., Talos I-F., Golby A.J., Wells III W.M., Kikinis R., Black P.M. A New Metric for Detecting Change in Slowly Evolving Brain Tumors: Validation in Meningioma Patients. Neurosurgery. 2011 Mar;68(1 Suppl Operative):225-33. PMID: 21206318. PMCID: PMC3099129.
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BACKGROUND: Change detection is a critical component in the diagnosis and monitoring of many slowly evolving pathologies. OBJECTIVE: This article describes a semiautomatic monitoring approach using longitudinal medical images. We test the method on brain scans of patients with meningioma, which experts have found difficult to monitor because the tumor evolution is very slow and may be obscured by artifacts related to image acquisition. METHODS: We describe a semiautomatic procedure targeted toward identifying difficult-to-detect changes in brain tumor imaging. The tool combines input from a medical expert with state-of-the-art technology. The software is easy to calibrate and, in less than 5 minutes, returns the total volume of tumor change in mm. We test the method on postgadolinium, T1-weighted magnetic resonance images of 10 patients with meningioma and compare our results with experts' findings. We also perform benchmark testing with synthetic data. RESULTS: Our experiments indicated that experts' visual inspections are not sensitive enough to detect subtle growth. Measurements based on experts' manual segmentations were highly accurate but also labor intensive. The accuracy of our approach was comparable to the experts' results. However, our approach required far less user input and generated more consistent measurements. CONCLUSION: The sensitivity of experts' visual inspection is often too low to detect subtle growth of meningiomas from longitudinal scans. Measurements based on experts' segmentation are highly accurate but generally too labor intensive for standard clinical settings. We described an alternative metric that provides accurate and robust measurements of subtle tumor changes while requiring a minimal amount of user input.

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