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Radiology. 2004 Jun;231(3):866-71.

Lung tumor growth: assessment with CT--comparison of diameter and cross-sectional area with volume measurements.

Author information

1
Department of Radiology, Indiana University School of Medicine, 950 W Walnut Street, Room E124, Indianapolis, IN 46202, USA. sajennin@iupui.edu

Abstract

PURPOSE:

To compare diameter and cross-sectional area measurements with volume measurements in the assessment of lung tumor growth with serial computed tomography (CT).

MATERIALS AND METHODS:

Patients with lung cancer who underwent at least one pair of chest CT examinations 25 or more days apart before treatment and with a tumor size of T1 (< or =3-cm diameter) at the initial CT examination were identified. A total of 63 patients (62 men, one woman) who underwent 93 pairs of CT examinations were included. Images obtained at each examination were displayed, and the maximum diameter, cross-sectional area, and volume of the tumor were measured. For each measurement, the change between examinations was assessed to determine whether the change reached a detection threshold for growth, as determined in a prior study with simulated tumors. Results were then compared between measurement methods, with volume change serving as the reference standard, by calculating Spearman rank-order coefficients between examinations. Tumor size or section width were also evaluated with the two-tailed Fisher exact probability test to determine if they affected agreement about tumor growth between measurement methods.

RESULTS:

Thresholds were as follows: diameter, 2.1 mm with hand-held calipers and 0.68 mm with electronic calipers; area, 9.4%; volume, 16.5%. The median time between examinations was 92 days (range, 25-1,221 days). Median diameter increased from 19.3 mm to 23.0 mm (19.2%), median area from 207 mm(2) to 267 mm(2) (29.0%), and median volume from 1,652 mm(3) to 2,443 mm(3) (47.9%). Growth assessment with these diameter (as assessed with hand-held and electronic calipers) and area thresholds disagreed with those obtained with volume in 34 (37%), 26 (28%), and 25 (27%) of the 93 pairs of CT examinations, respectively. Of diameter assessments with the hand-held caliper threshold, 28 (30%) were false-negative; false-negative results occurred with this diameter threshold and area threshold with examination intervals as long as 1 year.

CONCLUSION:

Growth assessment of T1 lung tumors on serial CT scans with nonvolumetric measurements frequently disagrees with growth assessment with volumetric measurements.

PMID:
15163822
DOI:
10.1148/radiol.2313030715
[Indexed for MEDLINE]

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