Device, equipment and medium for evaluating curative effect of lung metastasis of liver cancer

Abstract

The invention provides a liver cancer lung metastasis curative effect evaluation device, which is characterized by comprising an image data acquisition unit, a lung metastasis evaluation unit and a lung metastasis evaluation unit, a focus identification and segmentation unit; a parameter calculation unit; and a curative effect evaluation unit. The second aspect of the invention is to provide an electronic device. The third aspect of the invention is to provide a computer readable storage medium. In the tumor growth process, heterogeneity in all directions of a tumor body and morphological sign changes in the tumor frequently occur, and compared with one-dimensional measurement, three-dimensional volume measurement can more accurately capture overall changes of tumor growth. On the basis of the reasons, in today when the automatic volume measurement technology is increasingly mature, the invention proposes that the curative effect of the pulmonary metastatic tumor can be better evaluated according to the change of the volume sum or the mass sum through the total volume reaction and the total mass reaction.

Description

Technical Field

[0001] The present invention relates to a device, equipment and medium for evaluating the short-term efficacy of liver cancer lung metastasis patients after treatment, belonging to the technical field of medical imaging and computer image automatic recognition. Background Art

[0002] The evaluation of the efficacy of tumor treatment is a key link in tumor treatment. In large-scale clinical studies and clinical work, in addition to long-term efficacy evaluation indicators such as survival and progression-free survival, short-term efficacy evaluation after treatment is also crucial for tumor patients. The most commonly used are the Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1 and the modified Response Evaluation Criteria in Solid Tumours (mRECIST) version 1.1 based on the evaluation of the size of target lesions. This standard uses the measurement of the longest diameter of a tumor on a single level, and no more than two target lesions in a single organ. It is relatively simple and practical to operate in daily tumor assessment, and can better predict survival. However, the disadvantages of RECIST are also obvious. Measuring the longest diameter of a tumor on a single level, and no more than two target lesions in a single organ, is prone to deviation and cannot comprehensively and completely evaluate the tumor.

[0003] Taking lung metastases as an example, lung metastases are characterized by diffuse and multiple occurrences. At the same time, with the rise of targeted and immunotherapy in recent years, due to the existence of tumor heterogeneity, the lesions respond differently to targeted immunotherapy, and the RECIST standard can only evaluate two lesions in the lungs. If all metastatic lesions in a certain organ can be included in the evaluation objects and three-dimensional volume measurements can be performed, it will undoubtedly better reflect the overall situation of the lesions. However, another key factor in the evaluation of tumor efficacy is convenience. The evaluation of tumor efficacy has undergone a stage of transformation from the two-dimensional WHO standard to the one-dimensional RECIST standard. The shift from two-dimensional with more parameters to one-dimensional is because one-dimensional measurement is more convenient in clinical applications. Therefore, three-dimensional volume measurement is limited to the cumbersome manual measurement and has not yet been actually applied in clinical work. Summary of the invention

[0004] The technical problem to be solved by the present invention is that lung metastases are characterized by being diffuse and multiple, while the RECIST standard can only evaluate two lesions in the lung.

[0005] In order to solve the above technical problems, the first aspect of the present invention is to provide a device for evaluating the therapeutic effect of liver cancer lung metastasis, which is characterized by comprising:

[0006] An image data acquisition unit, used to obtain lung CT image data collected by a CT device;

[0007] A lesion recognition and segmentation unit, which is used to identify lesions based on lung CT image data and segment the disease edges of all lesions;

[0008] A parameter calculation unit is used to calculate the volume and mass of each lesion identified by the lesion identification and segmentation unit, and then further calculate the volume sum and mass sum of all lesions, and finally obtain the ratio of the volume sum to the mass sum;

[0009] The efficacy evaluation unit is used to evaluate the efficacy based on the number of lesions identified by the parameter calculation unit and the lesion identification and segmentation unit:

[0010] Case 1) If the lesion identification and segmentation unit does not identify the lesion, the evaluation result output by the efficacy evaluation unit is complete remission;

[0011] Case 2) If the ratio now Compared to the ratio before If it is reduced by A%, the evaluation result output by the efficacy evaluation unit is partial remission;

[0012] Case 3) If the ratio now Compared to the ratio before If it increases by B%, the evaluation result output by the efficacy evaluation unit is disease progression;

[0013] Case 4) If the ratio now Compared to the ratio before If the change is between situation 2) and situation 3), the evaluation result output by the efficacy evaluation unit is disease stability, where:

[0014] ratio now The ratio is the value calculated by the parameter calculation unit for the patient's current examination. before It is the ratio calculated by the parameter calculation unit during the patient's last examination; A% and B% are pre-set thresholds, and B%≤A%.

[0015] A second aspect of the present invention provides an electronic device, comprising:

[0016] one or more processors;

[0017] The storage device is used to store one or more programs, wherein when the one or more programs are executed by the one or more processors, the one or more processors execute software to implement the above-mentioned device.

[0018] The third aspect of the present invention is to provide a computer-readable storage medium having executable instructions stored thereon, which, when executed by a processor, causes the processor to execute and implement the above-mentioned device.

[0019] During tumor growth, heterogeneity in all directions of the tumor and changes in morphological signs within the tumor often occur. Three-dimensional volume measurement can more accurately capture the overall changes in tumor growth than one-dimensional measurement. Based on the above reasons, as the automatic volume measurement technology becomes increasingly mature, the present invention proposes that the total volume response and total mass response can be used to better evaluate the efficacy of lung metastases by the change in the sum of volume or the sum of mass. BRIEF DESCRIPTION OF THE DRAWINGS

[0020] Figure 1 The United Imaging uAI-ChestCare system automatically identifies lesions and segments the edges of lesions;

[0021] Figure 2 The relationship between the total volume and total mass change rate of lung metastatic lesions in patients with liver cancer and the diameter change rate under the RECIST1.1 standard is shown. DETAILED DESCRIPTION

[0022] The present invention will be further described below in conjunction with specific embodiments. It should be understood that these embodiments are only used to illustrate the present invention and are not intended to limit the scope of the present invention. In addition, it should be understood that after reading the content taught by the present invention, those skilled in the art can make various changes or modifications to the present invention, and these equivalent forms fall within the scope limited by the appended claims of the application equally.

[0023] The terms used herein are only for describing specific embodiments and are not intended to limit the present disclosure. The terms "comprise", "include", etc. used herein indicate the existence of the features, steps, operations and / or components, but do not exclude the existence or addition of one or more other features, steps, operations or components.

[0024] All terms (including technical and scientific terms) used herein have the meanings commonly understood by those skilled in the art, unless otherwise defined. It should be noted that the terms used herein should be interpreted as having a meaning consistent with the context of this specification, and should not be interpreted in an idealized or overly rigid manner.

[0025] When using expressions such as "at least one of A, B, and C, etc.", they should generally be interpreted according to the meaning of the expression commonly understood by those skilled in the art (for example, "a system having at least one of A, B, and C" should include but is not limited to a system having A alone, B alone, C alone, A and B, A and C, B and C, and / or A, B, C, etc.).

[0026] The detailed background technology may include other technical problems besides the technical problems solved by the claim alone.

[0027] The first aspect of the embodiment of the present invention discloses a device for evaluating the therapeutic effect of liver cancer lung metastasis, comprising the following units:

[0028] The image data acquisition unit is used to obtain lung CT image data in DICOM format acquired by a CT device. In the embodiment of the present invention, the CT device may be a CT device supporting a slice thickness of ≤1 mm, such as United Imaging uCT760 or GE Revolution CT.

[0029] The lesion recognition and segmentation unit is used to identify lesions based on lung CT image data and segment the disease edges of all lesions. In the embodiment of the present invention, the lesion recognition and segmentation unit is implemented using the lung nodule CT image-assisted detection software system (product model: uAI-ChestCare version number: R001) of Shanghai United Imaging Intelligent Medical Technology Co., Ltd. The system automatically identifies lesions and segments the results of lesion edges. Figure 1 shown.

[0030] The parameter calculation unit is used to calculate the volume and mass of each lesion identified by the lesion identification and segmentation unit, and then further calculate the volume sum and mass sum of all lesions to finally obtain the ratio of the volume sum to the mass sum.

[0031] In the embodiment of the present invention, the parameter calculation unit is also implemented based on the lung nodule CT image-assisted detection software system, through which the volume, long and short diameters, CT value and other related parameters of each identified lesion can be automatically counted. The mass of each lesion can be calculated from the volume and CT value, as shown in the following formula:

[0032] Mass = (CT value / 1000+1) × volume

[0033] In the above formula, the unit of mass is g and the unit of volume is mm 3 .

[0034] The parameter calculation unit adds up the volumes of all lesions to obtain the sum of the volumes of all lesions. At the same time, the masses of all lesions are added to obtain the sum of the masses of all lesions. The parameter calculation unit finally obtains the ratio of the sum of the volumes to the sum of the masses.

[0035] The efficacy evaluation unit is used to evaluate the efficacy based on the number of lesions identified by the parameter calculation unit and the lesion identification and segmentation unit:

[0036] Case 1) If the lesion identification and segmentation unit does not identify the lesion, the evaluation result output by the efficacy evaluation unit is complete remission;

[0037] Case 2) If the rationow Compared to the ratio before If the reduction is ≥30%, the evaluation result output by the efficacy evaluation unit is partial remission;

[0038] Case 3) If the ratio now Compared to the ratio before If the increase is ≥20%, the evaluation result output by the efficacy evaluation unit is disease progression;

[0039] Case 4) If the ratio now Compared to the ratio before If the change is between situation 2) and situation 3), the evaluation result output by the efficacy evaluation unit is disease stability, where:

[0040] ratio now The ratio is the value calculated by the parameter calculation unit for the patient's current examination. before Ratio calculated by the parameter calculation unit for the patient's last examination.

[0041] A total of 293 lesions were found in 20 cases of liver cancer lung metastasis before and after follow-up. The lesion volume and CT value were measured, and the CT value was converted into the tissue density of the lesion (g / cm3) = CT value / 1000+1. The lesion mass was calculated, and the lesion mass was 0.01-113.34 (1.98±8.00) g. There were 141 lesions at baseline, and the lesion mass was 0.01-48.89 (1.64±5.12) g; there were 152 lesions after follow-up, and the lesion mass was 0.01-113.34 (2.29±9.96) g.

[0042] The above device was used to calculate the total volume of lesions in follow-up CT scans of 20 patients with liver cancer lung metastasis, and the relative change relationship between the total volume change rate and the change rate of lung lesion diameter under the RECIST1.1 standard (no more than 2 lesions) was calculated. The scatter plot preliminarily determined that there was a linear trend between the two. After analyzing the data type, Spearman correlation analysis was performed, and the results showed that the change rates of the two were highly correlated (r = 0.800, P < 0.01, such as Figure 2 At the same time, the relative change relationship between the total change rate of lesion mass in follow-up CT scans and the change rate of lung lesion diameter under RECIST1.1 standard (no more than 2 lesions) was calculated. The scatter plot preliminarily determined that there was a linear trend between the two. After analyzing the data type, Spearman correlation analysis was performed. The results showed that the change rates of the two were highly correlated (r = 0.896, P < 0.01, as shown in Figure 2). Figure 2 shown).

[0043] When only pulmonary lesions were included in the evaluation, the number of patients for each response evaluation result was calculated by three different methods (RECIST1.1 standard, total volume response, and total mass response). When evaluated by RECIST1.1 standard, 2 cases (10%) could not be calculated because the maximum diameter of the largest lesion was less than 1 cm, 5 cases (25%) were evaluated as partial progression, and 13 cases (65%) were evaluated as stable. When evaluated by total volume response, 1 case (5%) was evaluated as partial improvement, 9 cases (45%) were evaluated as stable, and 10 cases (50%) were evaluated as partial progression. Compared with RECIST1.1 standard, the Kappa value between the two was 0.486 (p < 0.05), which was generally consistent.

[0044]

[0045] Table 1 RECIST1.1 criteria and total volume response assessment results of lung lesions in patients with liver cancer

[0046] When the overall quality response was evaluated, 2 cases (10%) were evaluated as partially improved, 8 cases (40%) were evaluated as stable, and 10 cases (50%) were evaluated as partially progressive. Compared with the RECIST1.1 standard, the Kappa value between the two was 0.426 (p < 0.05), which was generally consistent.

[0047]

[0048] Table 2 RECIST1.1 standard and overall quality response efficacy evaluation results of patients with liver cancer

[0049] In Tables 1 and 2, CR means complete remission, PR means partial remission, SD means stable disease, and PD means progressive disease. Figure 2 As can be seen from Table 1 and Table 2, the effect of the device of the embodiment of the present invention in evaluating the therapeutic effect through the ratio of the volume sum to the mass sum is consistent with the RECIST1.1 standard, thereby proving the effectiveness of the technical solution disclosed in the present invention.

[0050] The second aspect of the embodiment of the present invention discloses an electronic device including a processor, which can perform various appropriate actions and processes according to a program stored in a read-only memory (ROM) or a program loaded from a storage portion into a random access memory (RAM). The processor may include, for example, a general-purpose microprocessor (e.g., a CPU), an instruction set processor and / or a related chipset and / or a dedicated microprocessor (e.g., an application-specific integrated circuit (ASIC)), etc. The processor may also include an onboard memory for caching purposes. The processor may include a single processing unit or multiple processing units for performing different actions of the liver cancer lung metastasis efficacy evaluation device according to an embodiment of the present disclosure.

[0051] In RAM, various programs and data required for the operation of electronic devices are stored. The processor, ROM and RAM are connected to each other through a bus. The processor implements the above-mentioned liver cancer lung metastasis efficacy evaluation device by executing the program in ROM and / or RAM. It should be noted that the program can also be stored in one or more memories other than ROM and RAM. The processor can also perform various operations of the device according to the embodiment of the present disclosure by executing the program stored in the one or more memories.

[0052] According to an embodiment of the present disclosure, the electronic device may further include an input / output (I / O) interface, which is also connected to the bus. The electronic device may also include one or more of the following components connected to the I / O interface: an input part including a keyboard, a mouse, etc.; an output part including a cathode ray tube (CRT), a liquid crystal display (LCD), etc., and a speaker; a storage part including a hard disk, etc.; and a communication part including a network interface card such as a LAN card, a modem, etc. The communication part performs communication processing via a network such as the Internet. The drive is also connected to the I / O interface as needed. Removable media, such as disks, optical disks, magneto-optical disks, semiconductor memories, etc., are installed on the drive as needed so that the computer program read therefrom is installed into the storage part as needed.

[0053] The third aspect of the embodiments of the present invention further provides a computer-readable storage medium, which may be included in the device / apparatus described in the above embodiments; or may exist independently without being assembled into the device / apparatus. The above computer-readable storage medium carries one or more programs, and when the above one or more programs are executed, the above liver cancer lung metastasis efficacy evaluation device is implemented.

[0054] According to an embodiment of the present disclosure, the computer-readable storage medium may be a non-volatile computer-readable storage medium, for example, may include but is not limited to: a portable computer disk, a hard disk, a random access memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or flash memory), a portable compact disk read-only memory (CD-ROM), an optical storage device, a magnetic storage device, or any suitable combination of the above. In an embodiment of the present invention, the computer-readable storage medium may be any tangible medium containing or storing a program, which may be used by or in combination with an instruction execution system, an apparatus or a device. For example, according to an embodiment of the present disclosure, the computer-readable storage medium may include the ROM402 and / or RAM403 described above and / or one or more memories other than ROM402 and RAM403.

[0055] It will be appreciated by those skilled in the art that the features described in the various embodiments and / or claims disclosed in the present invention may be combined and / or combined in various ways, even if such combinations and / or combinations are not explicitly described in the present disclosure. In particular, the features described in the various embodiments and / or claims disclosed in the present invention may be combined and / or combined in various ways without departing from the spirit and teachings of the present disclosure. All of these combinations and / or combinations fall within the scope of the present disclosure.

[0056] The embodiments disclosed in the present invention are described above. However, these embodiments are only for the purpose of illustration, and are not intended to limit the scope of the present invention. Although the embodiments are described above respectively, this does not mean that the measures in the various embodiments cannot be used in combination to advantage. The scope of the present invention is defined by the attached claims and their equivalents. Without departing from the scope of the present invention, those skilled in the art may make various substitutions and modifications, which should all fall within the scope of the present invention.

Claims

1. A device for evaluating the therapeutic effect of liver cancer lung metastasis, characterized in that: include: An image data acquisition unit, used to obtain lung CT image data collected by a CT device; A lesion recognition and segmentation unit, which is used to identify lesions based on lung CT image data and segment the disease edges of all lesions; A parameter calculation unit is used to calculate the volume and mass of each lesion identified by the lesion identification and segmentation unit, and then further calculate the volume sum and mass sum of all lesions, and finally obtain the ratio of the volume sum to the mass sum; The efficacy evaluation unit is used to evaluate the efficacy based on the number of lesions identified by the parameter calculation unit and the lesion identification and segmentation unit: Case 1) If the lesion identification and segmentation unit does not identify the lesion, the evaluation result output by the efficacy evaluation unit is complete remission; Case 2) If the ratio now Compared to the ratio before If it is reduced by A%, the evaluation result output by the efficacy evaluation unit is partial remission; Case 3) If the ratio now Compared to the ratio before If it increases by B%, the evaluation result output by the efficacy evaluation unit is disease progression; Case 4) If the ratio now Compared to the ratio before If the change is between situation 2) and situation 3), the evaluation result output by the efficacy evaluation unit is disease stability, where: ratio now The ratio is the value calculated by the parameter calculation unit for the patient's current examination. before It is the ratio calculated by the parameter calculation unit during the patient's last examination; A% and B% are pre-set thresholds, and B%≤A%.

2. The device for evaluating the therapeutic effect of liver cancer lung metastasis according to claim 1, characterized in that: The lung CT image data is in DICOM format.

3. The device for evaluating the therapeutic effect of liver cancer lung metastasis according to claim 1, characterized in that: The parameter calculation unit obtains the volume and CT value of each region of interest, and calculates the mass based on the volume and CT value using the following formula: mass=(CT value / 1000+1)×volume.

4. The device for evaluating the therapeutic effect of liver cancer lung metastasis according to claim 1, characterized in that: In the case 2), A% is set to 30%.

5. The device for evaluating the therapeutic effect of liver cancer lung metastasis according to claim 1, characterized in that: In the case three), B% is set to 20%.

6. An electronic device comprising: one or more processors; A storage device for storing one or more programs, wherein when the one or more programs are executed by the one or more processors, the one or more processors are caused to execute software to implement the device according to claim 1.

7. A computer-readable storage medium having executable instructions stored thereon, which, when executed by a processor, causes the processor to implement the apparatus according to claim 1.

Images