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Lung tumor growth

Publication
Philips CT Clinical Science Philips Healthcare • USA

Comparison of diameter and cross-sectional area with volume measurements

Jennings SG, Winer-Muram HT, Tarver RD, Farber MO.

 

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

 

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 (≤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 mm² to 267 mm² (29.0%), and median volume from 1,652 mm³ to 2,443 mm³ (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 one year.

 

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

 

For more information on this publication, check out the PubMed listing for this article.



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Publication
Body, chest, lung cancer, lungs, Oncology, Thorax, tumor
 

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