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2013 ; 20
(6
): 675-84
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Assessing splenomegaly: automated volumetric analysis of the spleen
#MMPMID23535191
Linguraru MG
; Sandberg JK
; Jones EC
; Summers RM
Acad Radiol
2013[Jun]; 20
(6
): 675-84
PMID23535191
show ga
RATIONALE AND OBJECTIVES: To define systematic volumetric thresholds to identify
and grade splenomegaly and retrospectively evaluate the performance of
radiologists to assess splenomegaly in computed tomography (CT) image data.
MATERIALS AND METHODS: A clinical tool was developed to segment spleens from 172
contrast-enhanced clinical CT studies. There were 45 normal and 127 splenomegaly
cases confirmed by radiological reports. Spleen volumes were compared to manual
measurements using overlap/error. Volumetric thresholds for mild/massive
splenomegaly were defined at 1/2.5 standard deviations above the average splenic
volume of the healthy population. The thresholds were validated against consensus
reports. The performance of radiologists in assessing splenomegaly was
retrospectively evaluated. RESULTS: The automated segmentation of spleens was
robust with volume overlap/error of 95.2/3.3%. There were no significant
differences (P > .2) between manual and automated segmentations for either
normal/splenomegaly subgroups. Comparable correlations between interobserver and
manual-automated measurements were found (r = 0.99 for all). The average volume
of normal spleens was 236.89 ± 77.58 mL. For splenomegaly, average volume was
1004.75 ± 644.27 mL. Volumetric thresholds of 314.47/430.84 mL were used to
define mild/massive splenomegaly (±18.86 mL, 95% CI). Radiologists disagreed in
23.25% (n = 40) of the diagnosed cases. The area under the receiver operating
characteristic curve of the volumetric criterion for splenomegaly detection was
0.96. Using the volumetric thresholds as the reference standard, the sensitivity
of radiologists in detecting all/mild/massive splenomegaly was 95.0/66.6/99.0% at
78.0% specificity, respectively. CONCLUSION: Thresholds for the identification
and grading of splenomegaly from automatic volumetric spleen assessment were
introduced. The volumetric thresholds match well with clinical interpretations
for splenomegaly and may improve splenomegaly detection compared with splenic
cephalocaudal height measurements or visual inspection commonly used in current
clinical practice.
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