Volumetric analysis of pelvic hematomas after blunt trauma using semi-automated seeded region growing segmentation: a method validation study

• Published in: Abdominal imaging 2016-11, Vol.41 (11), p.2203-2208
• Main Authors: Dreizin, David, Bodanapally, Uttam K., Neerchal, Nagaraj, Tirada, Nikki, Patlas, Michael, Herskovits, Edward
• Format: Article
• Language: English
• Subjects: Abdominal Injuries - complications; Abdominal Injuries - diagnostic imaging; Adult; Aged; Aged, 80 and over; Angiography; Appraisals; Automation; Binders; Bleeding; Contrast Media; Correlation; Female; Gastroenterology; Hematoma; Hematoma - diagnostic imaging; Hematoma - etiology; Hepatology; Humans; Imaging; Male; Medicine; Medicine & Public Health; Methods; Middle Aged; Patients; Radiographic Image Interpretation, Computer-Assisted - methods; Radiology; Readers; Retrospective Studies; Segmentation; Tomography, X-Ray Computed; Trauma; Variance analysis; Volumetric analysis; Wounds, Nonpenetrating - complications
• ISSN: 2366-004X; 2366-0058
• DOI: 10.1007/s00261-016-0822-8

Objective Manually segmented traumatic pelvic hematoma volumes are strongly predictive of active bleeding at conventional angiography, but the method is time intensive, limiting its clinical applicability. We compared volumetric analysis using semi-automated region growing segmentation to manual segmentation and diameter-based size estimates in patients with pelvic hematomas after blunt pelvic trauma. Materials and methods A 14-patient cohort was selected in an anonymous randomized fashion from a dataset of patients with pelvic binders at MDCT, collected retrospectively as part of a HIPAA-compliant IRB-approved study from January 2008 to December 2013. To evaluate intermethod differences, one reader (R1) performed three volume measurements using the manual technique and three volume measurements using the semi-automated technique. To evaluate interobserver differences for semi-automated segmentation, a second reader (R2) performed three semi-automated measurements. One-way analysis of variance was used to compare differences in mean volumes. Time effort was also compared. Correlation between the two methods as well as two shorthand appraisals (greatest diameter, and the ABC/2 method for estimating ellipsoid volumes) was assessed with Spearman’s rho ( r ). Results Intraobserver variability was lower for semi-automated compared to manual segmentation, with standard deviations ranging between ±5–32 mL and ±17–84 mL, respectively ( p  = 0.0003). There was no significant difference in mean volumes between the two readers’ semi-automated measurements ( p  = 0.83); however, means were lower for the semi-automated compared with the manual technique (manual: mean and SD 309.6 ± 139 mL; R1 semi-auto: 229.6 ± 88.2 mL, p  = 0.004; R2 semi-auto: 243.79 ± 99.7 mL, p  = 0.021). Despite differences in means, the correlation between the two methods was very strong and highly significant ( r  = 0.91, p