Stereoloogiline meetod radioloogias. Rainer Uibo

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1 Stereoloogiline meetod radioloogias Rainer Uibo

2 Kusepõie mahu mõõtmine kui tüüpiline näide mõõtmismeetodite täpsuse ja keerulisuse kohta mudelid kuup (a3) kera (a3*0,523) ellipsoid (a*b*c*0,523) kogus urineerimisel sarnaste pikslite arv ristlõikepindalad*kihi paksus stereoloogia

3 Stereoloogia definitsioone science of geometrical relationships between a structure that exists in three dimensions and the planar sections of that structure that are fundamentally two-dimensional sampling theory for spatial processes the objective of stereology is to draw inferences about the geometrical properties of three-dimensional structures when information is only available in some lower-dimensional form via linear probes, planar sections, or projections of thin slices. stereoloogia 2D-kujutised 2D-kujutised 2D-kujutised

4 3D maailma muundumine 2D kujutistel Ruumala (V) lõikepindala (A) Piiripinna pindala (S) lõike ümbermõõt (B) Pikkus (L) Punktide arv (Q või I) Punkt ei sattu uuringualale Allikas: Russ J.C., Dehoff R.T. Practical Stereology (kohandatud)

5 Geomeetrilised parameetrid meetrilised ruumala pindala pikkus kõverus topoloogilised oskeste arv ühenduste arv

6 Stereoloogias kasutatavad sümbolid Pindala (A-area): (rist)lõike pindala 2D-kujutistel Piiripinna pikkus (B-boundary): (rist)lõike ümbermõõt 2Dkujutistel Pikkus (L-length): 3D-maailmas, näiteks taime juure pikkus Piiripindade pindala (S-surface): 3D-maailmas, näiteks ajukoore pindala Objekti ruumala (V-volume): 3D-maailmas, näiteks vasaku vatsakese maht Üksikobjekti ruumala kogumis (v-volume): 3D-maailmas, näiteks üksiku raku ruumala Üksikobjektide arv kogumis (N-number) Loendatud punktide arv (I või P või Q): 2D-kujutistel Allikas:

7 Uuritavate tasapindade tüübid lõikepind (mineraloogias) koelõik, lugemiskamber (histoloogias) rekonstruktsioon (radioloogias)

8 Stereoloogilise meetodi eeldused Me ei tea objektide arvu objektide asukohta objektide suunda objektide kuju Me teame objekti(de) hinnagulist läbimõõtu

9 Stereoloogiline meetod histoloogias Ruumala Piiripinna pindala Rakkude arv Kapillaaride kogupikkus Ühenduste (luutrabeekulite) arv Preparaadi ruumala erinevuse tõttu in vivo ja in vitro soovitatakse arvu loendamistel võrrelda absoluutväärtusi, mitte suhtena ruumalaühiku kohta

10 Delesse printsiip Homogeenses (stereoloogias: IUR tingimustega) ruumis on ühes ruumiosas vaadeldud ja ruumi kõikide punktite, pikkuste, pindalade ning ruumalade suhe võrdne Allikas1: Mandarim-De-Lacerda C.A. Stereological tools in biomedical research. An. Acad. Bras. Cinc 2003; 75:

11 IUR tingimused (1) Isotroopsus Uniformsus Randomiseeritus Enamasti bioloogilised koed on korrastatud arhitektuuriga (mitteisotroopsed) peame kasutama isotroopset sondi ja/või tasapindu Aksiaalkujutised on ruumis kindlalt orienteeritud, seega olemuselt mitteisotroopsed

12 Sondide tüübid geomeetriliste kujundite kogum punktide võre paralleelsed jooned tsükloidid

13 Fraktsionaator - osakeste lugemiseks osake loetakse sisse: kui on kogu ulatuses kastis kui puudutab kasti rohelist joont, kuid ei puuduta punast joont või selle pikendust Allikas:

14 Disektor - 3D osakeste lugemiseks Osake loetakse sisse, kui asub vaid alumisel tasapinnal Praktiline tegevus: loetakse kaks järjestikust kihti (fraktsionaatori sama asetsusega), alumise kihi tulemusest lahutatakse ülemine Allikas2: Allikas1:

15 Tsükloid korrapäraste struktuuride piiripindade hindamiseks Allikas: Zahradnik I. et al. Stereologic analysis of isolated rat ventricular myocytes using the method of vertical sections.

16 Praktilised väljundid radioloogias

17 Ruumala mõõtmine

18 Cavalieri meetod Ebakorrapärase kujuga objektide ruumala mõõtmiseks võib lõikepindalad liita ning korrutada lõikekihi paksusega Allikas:

19 2D kujundi pindala (A) 1cm Punktide arv (P=20) Loendatakse vaid need, punktid, mille parem ja alumine külg on kujundi sees pindala punkti kohta (a/p=d2=0,52=0,25cm2) punktide vahekaugus (d) Allikas1: (kohandatud) Allikas2: Hussain Z. et al. Estimation of breast volume and its variation during the menstrual cycle using MRI and stereology. Brit. J. Radiol. 1999; 72: (kohandatud)

20 3D kujundi ruumala (V) punktide arv igas kihis (P1+P2+...Pn) kihtide intervall (T) pindala punkti kohta (a/p=d2) punktide vahekaugus d soovitatavalt d=(v/250t)0,5, kus V on ennustatud ruumala Allikas1: Hussain Z. et al. Estimation of breast volume and its variation during the menstrual cycle using MRI and stereology. Brit. J. Radiol. 1999; 72: Allikas2: G:\Stereoloogia\em-turotial1 -area and volume.mht

21 3D kujundi ruumala arvutamise viga (CE coefficient of error) praktilised soovitused kõikide kihtide lugemisel olgu intervall T=1/10 mõõdetava organi paksusest, esimese kihi algus olgu juhuslik suurus, kuid 0 kuni T kaugusel nullkoordinaadist. Sisse loetud punktide arv olgu umbes 200. Sel juhul on CE umbes 0,03. loendamise optimeerimiseks võib kasutada nomogrammi, siis vaja teada objekti piiripindade pikkuse ja pindala ruutjuure suhet (kujundi keerukuse hindajat): B/A0,5 Allikas1: Allikas2: Stereology Course in Tartu. Gundersen, H.J.G. 2004

22 Vajalike punktide arvu määramine nomogrammilt Loetud punktide arvu (P) suurendamine parandab täpsust, kuid vähendab tööviljakust Vaja teada lubatav suhtelise standardvea määr ehk CE kujundi keerukus (B/A0,5) Lähtudes optimaalsest punktide arvust (P) ning objekti läbimõõdust (L), hinnangulisest ruumalast (V) kihtidevaheline intervall: T=L/10 punktide vahekaugus võrel: d=(v/pt)0,5

23 Allikas: Gundersen H.J.G. et Jensen E.B. The efficiency of systematic sampling in stereology and its prediction. J. Microsc. 1987; 147: (artikli autori kohandustega)

24 Meningioomi mahu mõõtmine kujundi keerukuse ehk piiripinna ja mahu suhte hindamine (B/A0,5) täpne mahu mõõtmine (NB! võre on asetatud igale kihile juhuslikult) Allikas: Roberts N. et al. the benefit of stereology for quantitative radiology. Brit. J. Radiol. 2000; 73:

25 Piiripinna pindala mõõtmine

26 Parun Buffon' probleem Kui suur on tõenäosus, et õhku visatud nõel maandub ühe otsaga põranda prao peale? Allikas:

27 Stereoloogide pöördküsimus Kui pikad on õhku visatud nõelad, mis on kindel arv kordi maandunud joone peale? Kui suur on juhusliku kujuga objekti ümbermõõt? Allikas: Mandarim-De-Lacerda C.A. Stereological tools in biomedical research. An. Acad. Bras. Cinc 2003; 75:

28 Piiripinna mõõtmine isotroopsetelt tasapindadelt (Baddeley A.J. et al 1986) IUR tingimused isotroopselt valitud tasapinnad sondi sirgjoonte kogupikkus (L) sirgjoonega kokkupuutes olevate objekti kontuuri punktide arv (I) objekti ruumala (V)

29 Piiripinna pindala mõõtmine vertikaalsetelt tasapindadelt (Michel et Cruz-Orive 1988) IUR tingimused juhuslikult valitud paralleelsed vertikaalkihid, mille peale on joonistatud isotroopsed jooned isotroopse joone ja obekti kontuuri kokkupuutepunktide arv (I) tsükloidi kaare pindala kaare pikkuse kohta (A/L) kihtide intervall (T) Allikas: Roberts N. et al. the benefit of stereology for quantitative radiology. Brit. J. Radiol. 2000; 73:

30 IUR tingimused (1) orientaator vertikaaltasapindade ilmakaare valimiseks orientatsioon valitakse juhuslikult, näiteks: juhuslik arv vahemikus 0180 kraadi arvuti poolt genereeritud juhuslik arv ei ole päris juhuslik, soovitav kasutada juhuslike arvude tabelit Allikas:

31 IUR tingimused (2) Poolringide puutujate suunad on ruumis võrdselt jaotunud sondi parameetrid: pikkus pindala kohta (A/L) tsükli joone pikkus (L=2πr) tsükliga haarav pindala (A=8r2) A/L=4r/π NB! mitte segi ajada tsükloidiga, millel L=8r ; A=2r 2πr=4πr2 ning A/L=πr/2 Allikas:

32 Valik vertikaalseid tasapinnalisi rekonstruktsioone (mõõtmiseks piisab ühest komplektist) Allikas: Roberts N. et al. the benefit of stereology for quantitative radiology. Brit. J. Radiol. 2000; 73:

33 Isotroopsed jooned: tsükloidid Allikas: Roberts N. et al. the benefit of stereology for quantitative radiology. Brit. J. Radiol. 2000; 73:

34 Suuraju koore pindala T=1,5cm; a/l=2,9805cm Loendamisel saadi vasemal I=108; paremal I=139 Vastavalt valemile on ajukoore pindala vasemal S=967cm2; paremal S=1244cm2 Mõõtmist rakendati 12 korda, keskväärtuseks kujunes vasemal S=979; paremal S=1035cm2, arvutatud CE=3,9% Allikas: Roberts N. et al. the benefit of stereology for quantitative radiology. Brit. J. Radiol. 2000; 73:

35 Kollete arvu mõõtmine

36 Kollete arvu mõõtmine Radioloogiliste uuringute jaoks stereoloogilise meetodi kirjeldust ei õnnestunud leida keerulisem kui esialgu näib, sest suurtel kolletel on suurem tõenäosus sattuda vaatevälja lõpliku paksusega kihi korral kolded summeeruvad

37 Praktilised rakendused

38 Näiteid stereoloogia-alaste artiklite kohta radioloogias (1) (1) Gong, Q.Y. et al. Estimation of body composition in muscular dystrophy by MRI and stereology. J. Magn. Reson. Imaging 2000;12: (2) Andersen H. et al. Muscular atrophy in diabetic neuropathy: a stereological magnetic resonance imaging study. Diabetologia 1997; 40: (3) Collinson S.J. Et al. Brain volume, asymmetry and intellectual impairment in relation to sex in early-onset schizophrenia. Br. J. Psyhciatry 2003; 183:

39 Näiteid stereoloogia-alaste artiklite kohta radioloogias (2) (4) Hussain Z. et al. Estimation of breast volume and its variation during the menstrual cycle using MRI and stereology. Br. J. Radiol. 1999; 72: (5) Graves M.J. et Dommett D.M.F. Comparison of cardiac stroke volume measurement determine using stereological analysis of breath-hold cine MRI and phase contrast velocity mapping. Br. J. Radiol. 2000; 73:

40 Näiteid stereoloogia-alaste artiklite kohta radioloogias (3) (6) Keller S.S. et al. Voxel based morphometry of grey matter abnormalities in patients with medically intractable temporal lobe epilepsy: effects of side of seizure onset and epilepsy duration. J. Neurol Neurosurg Psychiatry 2002; 73: (7) Liu C. et al. Three dimensional MRI estimates of brain and spinal cord atrophy in multiple sclerosis. J. Neurol Neurosurg Psychiatry 1999; 66:

41 Näiteid stereoloogia-alaste artiklite kohta radioloogias (4) (8) Gong Q.Y. et al. Determination of tumour regression rates during radiotherapy for cervical carcinoma by serial MRI: comparison of two measurement techniques and examination of intraobserver and interobserver variability. Br. J. Radiol. 1999; 72: 62-72

42 Näiteid stereoloogia-alaste artiklite kohta radioloogias (5) rinna mahu mõõtmine (Hussain Z. et al. 1999) südame löögimahu mõõtmine (Gong Q.Y. et al. 1999)

43 Artiklites kasutatud kujutiste parameetrid

44 Vea suuruse valimine (CV)2=(CVR)2+(CE)2 (Gundersen H.J.G. et Osterby R. 1981) CVR tähistab biological coefficient of variation Kui soovitakse 95%-lise tõenäosusega leida keskmiste 10%-list erinevust ning kahe sõltumatu grupi vaheline variatsioon on 10%, 20% või 30%, siis vajalik uuritavate arv on vastavalt 7, 22, või 50. Allikas: Roberts N. et al. the benefit of stereology for quantitative radiology. Brit. J. Radiol. 2000; 73:

45 Süstemaatilised vead ehk nihked

46 Raskused objektiivsetel mõõtmistel Tegelikel mõõtmistel ei saa me süstemaatilise vea (ingl. k. bias) tõttu kunagi teada märklaua keskpunkti asukohta, kuid me peaksime püüdlema selles suunas Allikas:

47 Stereoloogiline meetod süstemaatilisi vigu ei sisalda. Nihke annavad kujutise hankimise ja töötlemise protsessid ning kujutise kihi lõplik paksus ning lahutusvõime.

48 Punkti hägusus (Point Spread Function) Allikas:

49 Keskpärane kujutis ehk Partial Volume Averaging Allikas:

50 Holmes'i efekt objekti suuruse ja osakeste koguruumala hindamisel Allikas1: Allikas2: Mandarim-De-Lacerda C.A. Stereological tools in biomedical research. An. Acad. Bras. Cinc 2003; 75:

51 Raskused mõõtmisel (1) Allikas: Therasse P. et al. New guidelines to evaluate the response to treatment in solid tumors. J. Nation. Cancer Inst. 2000; 92: (

52 Raskused mõõtmistel (2) Allikas: Therasse P. et al. New guidelines to evaluate the response to treatment in solid tumors. J. Nation. Cancer Inst. 2000; 92: (

53 Raskused mõõtmistel (3) Allikas: Therasse P. et al. New guidelines to evaluate the response to treatment in solid tumors. J. Nation. Cancer Inst. 2000; 92: (

54 Füsioloogilised liigutusartefaktid hingamine südametegevus veresoonte pulsatsioonid sooletegevus Allikas: Roberts N. et al. the benefit of stereology for quantitative radiology. Brit. J. Radiol. 2000; 73:

55 MRT lisaartefaktid keemiline nihe (chemical shift) magnetvälja lokaalne ebaühtlus (susceptibility) magnetvälja üldine ebaühtlus FOV kalibratsiooni ebatäpsus kihi paksuse kalibratsiooni ebatäpsus Allikas: Roberts N. et al. the benefit of stereology for quantitative radiology. Brit. J. Radiol. 2000; 73:

56 Arvutiprogrammid stereoloogilise mõõtmise lihtsustamiseks

57 Arvutiprogrammid ImageJ + plugin (tasuta, JAVA) VoluMeasure (500$ asutusele, JAVA) ANALYZE ($$$, MS Windows) mitmesugused histoloogilisteks mõõtmisteks mõeldud programmid

58 ANALYZE (TM) Allikas:

59 Eelised spetsiaalne programm radioloogiliste kujutiste jaoks palju võimalusi (rekonstruktsioonid, DICOM jne.) Mayo Kliiniku pidev arendustöö teaduskirjanduses laialt kasutatud Puudused kallis ainult MS Windows platvormil

60 VoluMeasure (TM) Allikas:

61 Vaja teada Vaja teada Pikslite maatriksi suurus (näiteks: 512x512) Pikseli suurus (mm-tes) Kihi intervall (mm-tes) Võre punkti suurus (pikslites, näiteks: 8)

62 Eelised spetsiaalselt mahu mõõtmiseks radioloogilistelt kujutistelt hindab aega, mis kulub kujutiste hindamiseks (töö efektiivsust) -JAVA platvorm Puudused puuduvad lisavõimalused

63 ImageJ Allikas:

64 Eelised tasuta JAVA platvorm palju lisavõimalusi (plugin), mis muudavad programmi väga paindlikuks Puudused lisavõimalused on keerulised installeerida

65 Kokkuvõte

66 Stereoloogiline meetod on 3D mõõtmiste kuldstandard By the year 2000, many journal editors and reviewers, regulatory agencies, and funding organizations began to state preferences for new stereology approaches, which they regarded as the state-of-the-art methodology for the morphological quantification of biological tissue. Allikas:

67 a V =T P1 P2... Pn p a S=2T I l

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