Treatment Response Assessment for XXXX on CT Based on Computerized Volume Analysis, World Health Organization Criteria, and RECIST.

@entity5 @entity1 @entity150
OBJECTIVE: The purpose of this study was to evaluate the accuracy of our autoinitialized cascaded level set 3D segmentation system as compared with the World Health Organization (WHO) criteria and the Response Evaluation Criteria In @entity5 (RECIST) for estimation of treatment response of @entity150 in CT urography. MATERIALS AND METHODS: CT urograms before and after neoadjuvant chemo-therapy treatment were collected from 18 @entity1 with muscle-invasive localized or locally advanced @entity150 . The disease stage as determined on pathologic samples at cystectomy after chemotherapy was considered as reference standard of treatment response. Two radiologists measured the longest diameter and its perpendicular on the pre- and posttreatment scans. Full 3D contours for all @entity5 were manually outlined by one radiologist. The autoinitialized cascaded level set method was used to automatically extract 3D @entity5 boundary. The prediction accuracy of pT0 disease (complete response) at cystectomy was estimated by the manual, autoinitialized cascaded level set, WHO, and RECIST methods on the basis of the AUC. RESULTS: The AUC for prediction of pT0 disease at cystectomy was 0.78    0.11 for autoinitialized cascaded level set compared with 0.82    0.10 for manual segmentation. The difference did not reach statistical significance (p = 0.67). The AUCs using RECIST criteria were 0.62    0.16 and 0.71    0.12 for the two radiologists, both lower than those of the two 3D methods. The AUCs using WHO criteria were 0.56    0.15 and 0.60    0.13 and thus were lower than all other methods. CONCLUSION: The pre- and posttreatment 3D volume change estimates obtained by the radiologist's manual outlines and the autoinitialized cascaded level set segmentation were more accurate for irregularly shaped @entity5 than were those based on RECIST and WHO criteria.
