Three-Dimensional Stereoscopic Volume Rendering of Malignant Pleural Mesothelioma

Mollberg, Nathan M.; Parsad, Nigel M.; Armato, Samuel G.; Vigneswaran, Janani; Kindler, Hedy L.; Sensakovic, William F.; Salgia, Ravi; Silverstein, Jonathan C.; Vigneswaran, Wickii T.

doi:10.9738/cc66.1

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…The 39 works on this subject deal primarily with the advantages of three-dimensional viewing of imaging examinations for attending surgeons-for example, in the case of a pleural mesothelioma [1] for the thoracic surgeon, a neurosurgeon's preparations for an operation on an intracranial aneurysm [2], or for neurosurgery in general [3,4]. Further publications report applications in gynecology [5] and otolaryngology [6].…”

Section: Modification Of the Density Values (Ct) Or Intensity Values mentioning

confidence: 99%

Stereoscopic Volume Rendering of Medical Imaging Data for the General Public

Fellner¹,

Berger²

2016

J Health Med Informat

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Section: Modification Of the Density Values (Ct) Or Intensity Values mentioning

confidence: 99%

Stereoscopic Volume Rendering of Medical Imaging Data for the General Public

Fellner¹,

Berger²

2016

J Health Med Informat

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A Multicenter Study of Volumetric Computed Tomography for Staging Malignant Pleural Mesothelioma

Rusch

Gill

Mitchell

et al. 2016

The Annals of Thoracic Surgery

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Background Standard imaging modalities are inaccurate in staging malignant pleural mesothelioma (MPM). Single institution studies suggest that volumetric computed tomography (VolCT) is more accurate but labor intensive. We established a multicenter network to test interobserver variability, accuracy (relative to pathologic stage) and prognostic significance of semi-automated VolCT. Methods Six institutions electronically submitted clinical and pathologic data to an established multicenter database on patients with MPM who had surgery. Institutional radiologists reviewed preoperative CT scans for quality then submitted via electronic network (AG mednet) to biostatistical center (BC). Two reference radiologists, blinded to clinical data, performed semi-automated tumor volume calculations using commercially available software (Vitrea Enterprise 6.0), then submitted readings to BC. Study endpoints included: feasibility of network; interobserver variability for VolCT; correlation of tumor volume to pTN stages, and overall survival (OS). Results Of 164 cases, 129 were analyzable and read by reference radiologists. Most tumors were <500cm3. A small bias was observed between readers, as one provided consistently larger measurements than the other (mean difference=47.9, p=.0027), but for 80% of cases, the absolute difference was ≤ 200cm3. Spearman correlation between readers was 0.822. Volume correlated with pTN stages and OS, best defined by 3 groups with average volumes of: 91.2, 245.3, 511.3cm3, associated with median OS of 37, 18, 8 months respectively. Conclusions For the first time, a multicenter network was established and initial correlations of tumor volume to pTN stages and OS shown. A larger multicenter international study is planned to confirm results and refine correlations.

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Delayed-Phase Enhancement for Evaluation of Malignant Pleural Mesothelioma on Computed Tomography: A Prospective Cohort Study

Patel

Roshkovan

McNulty

et al. 2021

Clinical Lung Cancer

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Malignant pleural mesothelioma (MPM) can be challenging to discriminate from adjacent tissues on computed tomography (CT), leading to errors in tumor assessment. Here we demonstrate that by increasing the CT time delay for imaging acquisition after intravenous contrast administration, improved tumor enhancement and conspicuity is achieved. These data support further study of delayed phase contrast CT imaging in MPM. Background: Radiologic assessment of malignant pleural mesothelioma (MPM) on computed tomography (CT) imaging can be limited by similar attenuations of MPM and adjacent tissues. This can result in inaccuracies in defining the presence and extent of pleural tumor burden. We hypothesized that increasing the time delay for pleural enhancement will optimize discrimination between MPM and noncancerous tissues on CT. Here we conduct a prospective observational study to determine the optimal time delay for imaging MPM on CT. Patients and Methods: Adult MPM patients (n ¼ 15) were enrolled in this prospective exploratory imaging trial. Patients with < 1 cm MPM thickness, prior pleurectomy, pleurodesis, pleural radiotherapy, or antiangiogenic therapy were excluded. All patients underwent a dynamically-enhanced CT with multiple time delays (0 -10 minutes) after intravenous contrast administration. Tumor tissue attenuation was measured at each phase of enhancement. A qualitative assessment of tumor enhancement kinetics was also performed. The optimal phase of enhancement based on qualitative lesion conspicuity and quantitative tumor enhancement was then compared. Results: MPM tumor enhancement was quantitatively and qualitatively increased at time delays beyond the conventional time delay for thoracic CT imaging (40-60 seconds). Patient tumor enhancement kinetics, displayed as the fraction of maximal tumor tissue attenuation as a function of time, revealed an optimal time delay of 230 to 300 seconds after intravenous contrast administration. There was an association between degree of tumor enhancement and subjective lesion conspicuity. Conclusion: Optimal MPM contrast enhancement occurs at a later phase than typically acquired with conventional thoracic CT imaging.

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Three-Dimensional Stereoscopic Volume Rendering of Malignant Pleural Mesothelioma

Cited by 3 publications

References 8 publications

Stereoscopic Volume Rendering of Medical Imaging Data for the General Public

Stereoscopic Volume Rendering of Medical Imaging Data for the General Public

A Multicenter Study of Volumetric Computed Tomography for Staging Malignant Pleural Mesothelioma

Delayed-Phase Enhancement for Evaluation of Malignant Pleural Mesothelioma on Computed Tomography: A Prospective Cohort Study

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