Three-Dimensional Volumetric Segmentation of Pituitary Tumors: Assessment of Inter-rater Agreement and Comparison with Conventional Geometric Equations

Karl Lindberg; Angelica Kouti; Doerthe Ziegelitz; Tobias Hallén; Thomas Skoglund; Dan Farahmand

doi:10.1055/s-0037-1618577

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base 2018; 79(05): 475-481
DOI: 10.1055/s-0037-1618577

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Three-Dimensional Volumetric Segmentation of Pituitary Tumors: Assessment of Inter-rater Agreement and Comparison with Conventional Geometric Equations

Karl Lindberg

¹Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden

²Department of Neuroradiology, Sahlgrenska University Hospital, Gothenburg, Sweden

,

Angelica Kouti

²Department of Neuroradiology, Sahlgrenska University Hospital, Gothenburg, Sweden

,

Doerthe Ziegelitz

²Department of Neuroradiology, Sahlgrenska University Hospital, Gothenburg, Sweden

,

Tobias Hallén

¹Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden

,

Thomas Skoglund

¹Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden

³Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

,

Dan Farahmand

¹Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden

³Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

› Author Affiliations

Abstract

Background The assessment of pituitary tumor (PT) volume is important in the treatment and follow-up of patients with PT. Previously, PT volume estimation has been performed by conventional geometric equations (CGE) such as abc/2 (simplified ellipsoid volume equation) and 4πr³/3 (sphere), both presuming a symmetric tumor shape, which occurs uncommonly in patients with PT. In contrast, three-dimensional (3D) voxel-based software segmentation takes the irregular and asymmetric shapes that PTs often possess into account and might be a more accurate method for PT volume segmentation.

The purpose of this study is twofold. (1) To compare 3D segmentation with CGE for PT volume estimation. (2) To assess inter-rater reliability in 3D segmentation of PTs.

Methods Nineteen high-resolution (1mm slice thickness) T1-weighted MRI examinations of patients with PT were independently analyzed and manually segmented, using the software ITK-SNAP, by two certified neuroradiologists. Concurrently, the volumes of the PTs were estimated with abc/2 and 4πr³/3 by a clinician, and the results were compared with the corresponding segmented volumes.

Results There was a significant decrease in PT volume attained from the segmentations compared with the calculations made with abc/2 (p < 0.001, mean volume 18% higher than segmentation) and 4πr³/3 (p < 0.001, mean volume 28% higher than segmentation). The intraclass correlation coefficient (ICC) for the two sets of segmented PTs was 0.99.

Conclusion CGE (abc/2 and 4πr³/3) significantly overestimates PT volume compared with 3D volumetric segmentation. The inter-rater agreement on manual 3D volumetric software segmentation is excellent.

Keywords

pituitary tumor volume - volumetric analysis - segmentation - abc/2

Full Text

References

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