Tejus Pradeep1, Gagan Kalra2, Joseph K Leader3,4, Jennifer McCoy5, Ronak Dixit6, Joseph Dohar6, Allison Tobey6, José-Alain Sahel7, Jiantao Pu8,9, Roxana Fu10. 1. School of Medicine, Johns Hopkins University, Baltimore, MD, USA. 2. Government Medical College and Hospital, Chandigarh, India. 3. Department of Radiology, University of Pittsburgh, Pittsburgh, PA, 15213, USA. 4. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15213, USA. 5. UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA. 6. Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 7. Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA. 8. Department of Radiology, University of Pittsburgh, Pittsburgh, PA, 15213, USA. puj@upmc.edu. 9. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15213, USA. puj@upmc.edu. 10. Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA. fur3@upmc.edu.
Abstract
INTRODUCTION: Our objective was to assess the utility of using lesion-mapping software to calculate precise orbital volumes to predict patients who would benefit from early surgical intervention. METHODS: We retrospectively reviewed patients diagnosed with subperiosteal orbital abscess (SPOA) secondary to sinusitis at a tertiary pediatric hospital from 2005 to 2016. Diagnoses were confirmed by CT scans. Lesion-mapping software was used to measure SPOA volume using initial CT images. Data collected included patient demographics, length of hospital stay, and subsequent medical or surgical treatment. RESULTS: Thirty-three (52%) patients ultimately underwent surgical intervention, while 30 (48%) were managed medically. Between the surgical and medical groups, there were no differences in gender, age, or comorbidities. The surgical group had larger abscess volumes than the medically managed group (0.94 mL vs. 0.31 mL, p < 0.01). Overall, increased SPOA volume was associated with increased age (Pearson's coefficient = 0.374, p ≤ 0.01) and increased total days of intravenous (IV) antibiotic administration (Pearson's coefficient = 0.260, p = 0.039). Patients who underwent surgery on the day of admission had 25% shorter hospital stay than patients who had delayed surgery (p < 0.01). Our calculated sensitivity-optimized SPOA volume cutoff of 0.231 mL yielded sensitivity of 90.9% and specificity of 70.0%. CONCLUSIONS: This is the first study to use lesion-mapping software for precise calculation of SPOA volumes, which can help refine indications for early surgical intervention and help decrease length of hospital stay.
INTRODUCTION: Our objective was to assess the utility of using lesion-mapping software to calculate precise orbital volumes to predict patients who would benefit from early surgical intervention. METHODS: We retrospectively reviewed patients diagnosed with subperiosteal orbital abscess (SPOA) secondary to sinusitis at a tertiary pediatric hospital from 2005 to 2016. Diagnoses were confirmed by CT scans. Lesion-mapping software was used to measure SPOA volume using initial CT images. Data collected included patient demographics, length of hospital stay, and subsequent medical or surgical treatment. RESULTS: Thirty-three (52%) patients ultimately underwent surgical intervention, while 30 (48%) were managed medically. Between the surgical and medical groups, there were no differences in gender, age, or comorbidities. The surgical group had larger abscess volumes than the medically managed group (0.94 mL vs. 0.31 mL, p < 0.01). Overall, increased SPOA volume was associated with increased age (Pearson's coefficient = 0.374, p ≤ 0.01) and increased total days of intravenous (IV) antibiotic administration (Pearson's coefficient = 0.260, p = 0.039). Patients who underwent surgery on the day of admission had 25% shorter hospital stay than patients who had delayed surgery (p < 0.01). Our calculated sensitivity-optimized SPOA volume cutoff of 0.231 mL yielded sensitivity of 90.9% and specificity of 70.0%. CONCLUSIONS: This is the first study to use lesion-mapping software for precise calculation of SPOA volumes, which can help refine indications for early surgical intervention and help decrease length of hospital stay.
Entities:
Keywords:
3D volume rendering; Computed tomography (CT); Orbital cellulitis; Subperiosteal orbital abscess