MDCT quantification is the dominant parameter in decision-making regarding chest tube drainage for stable patients with traumatic pneumothorax

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• 作者：Wenli Cai^a ; ^{Cai.Wenli@mgh.harvard.edu}  ; [Author Vitae] ; June-Goo Lee^a  ; [Author Vitae] ; Karim Fikry^b  ; [Author Vitae] ; Hiroyuki Yoshida^a  ; [Author Vitae] ; Robert Novelline^a  ; [Author Vitae] ; Marc de Moya^b  ; [Author Vitae]
• 关键词：Computer-aided volumetry (CAV) ; Computer-aided diagnosis (CAD) ; Decision-making ; Multi-detector computed tomography (MDCT) ; Pneumothorax ; Chest tube drainage
• 刊名：Computerized Medical Imaging and Graphics
• 出版年：2012
• 期刊代码：69_08956111
• 类别：med
• 出版时间：July, 2012
• 卷：36
• 期：5
• 页码：375-386
• 文件大小：1828 K

摘要

It is commonly believed that the size of a pneumothorax is an important determinant of treatment decision, in particular regarding whether chest tube drainage (CTD) is required. However, the volumetric quantification of pneumothoraces has not routinely been performed in clinics. In this paper, we introduced an automated computer-aided volumetry (CAV) scheme for quantification of volume of pneumothoraces in chest multi-detect CT (MDCT) images. Moreover, we investigated the impact of accurate volume of pneumothoraces in the improvement of the performance in decision-making regarding CTD in the management of traumatic pneumothoraces. For this purpose, an occurrence frequency map was calculated for quantitative analysis of the importance of each clinical parameter in the decision-making regarding CTD by a computer simulation of decision-making using a genetic algorithm (GA) and a support vector machine (SVM). A total of 14 clinical parameters, including volume of pneumothorax calculated by our CAV scheme, was collected as parameters available for decision-making. The results showed that volume was the dominant parameter in decision-making regarding CTD, with an occurrence frequency value of 1.00. The results also indicated that the inclusion of volume provided the best performance that was statistically significant compared to the other tests in which volume was excluded from the clinical parameters. This study provides the scientific evidence for the application of CAV scheme in MDCT volumetric quantification of pneumothoraces in the management of clinically stable chest trauma patients with traumatic pneumothorax.