目的:探讨商业可用半自动肺结节分割软件评估亚实性结节(SSNs)体积及体质量测量的可重复性,并比较其在观察者内及观察者间的差异.方法:回顾性收集自2016年6月1日至2019年12月31日在河北省人民医院行胸部CT检查并发现SSNs的患者117例,共163个SSNs的影像资料.两位放射科医师对入组SSNs进行二维(2D)体积、三维(3D)体积及体质量重复测量.使用Bland-Altman法评估SSNs体积及体质量测量观察者内和观察者间的变化度,Wilcoxon法比较以上两者变异度的差异.结果:共163个SSNs入组,3D体积和体质量测量观察者内变异度的组内相关系数为0.999,3D体积和体质量测量观察者间变异度的组内相关系数为0.999.对于体积测量,2D体积测量方法观察者内及观察者间的变异性分别为-25.1%~24.6%、-32.0%~30.3%,3D体积测量方法观察者内及观察者间的变异性分别为-16.7%~13.7%、-15.0%~13.5%.对于3D体质量测量,观察者内变异性分别为-7.8%~8.2%,观察者间变异性分别为-11.0%~9.7%.3D体积和体质量测量方法在观察者内和观察者间的变异性差异均无统计学意义(均P>0.05).结论:商业可用半自动肺结节分割软件在SSNs的体质量测量中具有较好重复性,可用作SSNs随访生长定量评估方法.
Objective:To investigate the reproducibility of volume and mass measurements assessed by commercially available pulmonary nodule segmentation software and to compare intraobserver and interobserver differences.Methods:From June 1,2016 to December 31,2019,image data of 163 SSNs found in 117 patients who underwent chest CT examination in Hebei Provincial People's Hospital were retrospectively collected.The two-dimensional(2D)volume,three-dimensional(3D)volume and mass of the enrolled SSNs were measured with volumetric software by two radiologists.Bland-Altman method was used to compare intraobserver and interobserver variability,and Wilcoxon method was used to compare the variance between the two.Results:A total of 163 SSNs were included.The intra-observer correlation coefficient of 3D mass and volume measurement variability was 0.999 and the interobserver correlation coefficient of 3D mass and volume measurement variability was 0.999.As for two-dimensional volume measurement,intraobserver and interobserver variability ranged from-25.1%to 24.6%and from-32.0%to 30.3%respectively,in contrast to the range from-16.7%to 13.7%and from-15.0%to 13.5%,respectively,for the three-dimensional volume measurement.As for the three-dimensional mass measurement,the intrao-bserver and interobserver variability ranged from-7.8%to 8.2%and from-11.0%to 9.7%,respectively.No significant difference was found for intra-observer and interobserver variability between 3D volume and mass measurements(P>0.05).Conclusion:The commercially available semi-automatic pulmonary nodule segmentation software has good repeatability in the quality measurement of SSNs,which can be used as a quantitative assessment method for the follow-up growth of SSNs.