Evaluation of tumor measurements in oncology: Use of film-based and electronic techniques

Departments of Radiology and Medical Physics, Memorial Sloan-Kettering Cancer Center, and Weill Medical College at Cornell University, New York, NY, 10021-6007, USA.
Journal of Clinical Oncology (Impact Factor: 18.43). 06/2000; 18(10):2179-84.
Source: PubMed

ABSTRACT To evaluate the variability in bidimensional computed tomography (CT) measurements obtained of actual tumors and of tumor phantoms by use of three measurement techniques: hand-held calipers on film, electronic calipers on a workstation, and an autocontour technique on a workstation.
Three radiologists measured 45 actual tumors (in the lung, liver, and lymph nodes) on CT images, using each of the three techniques. Bidimensional measurements were recorded, and their cross-products calculated. The coefficient of variation was calculated to assess interobserver variability. CT images of 48 phantoms were measured by three radiologists with each of the techniques. In addition to the coefficient of variation, the differences between the cross-product measurements of tumor phantoms themselves and the measurements obtained with each of the techniques were calculated.
The differences between the coefficients of variation were statistically significantly different for the autocontour technique, compared with the other techniques, both for actual tumors and for tumor phantoms. There was no statistically significant difference in the coefficient of variation between measurements obtained with hand-held calipers and electronic calipers. The cross-products for tumor phantoms were 12% less than the actual cross-product when calipers on film were used, 11% less using electronic calipers, and 1% greater using the autocontour technique.
Tumor size is obtained more accurately and consistently between readers using an automated autocontour technique than between those using hand-held or electronic calipers. This finding has substantial implications for monitoring tumor therapy in an individual patient, as well as for evaluating the effectiveness of new therapies under development.

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    ABSTRACT: BACKGROUND Bidimensional tumor measurements are used routinely as surrogates for tumor volume. The purpose this study was to determine whether there is any added benefit in bidimensional or tridimensional measurements over a unidimensional measurement.METHODS Sixty-nine colorectal hepatic metastases on 19 computed tomography scans (1–8 lesions per scan) from 9 patients were analyzed. Five patients contributed 2–4 scans each (mean, 3 scans). The standard volume of these lesions was determined by the “summation of areas” technique. The maximum axial dimension, the product of the greatest axial dimensions, and several volume estimates (based on the volumes of a sphere, an ellipsoid, and a cube) each were correlated with the standard volume.RESULTSThe maximum axial dimension and the product of the greatest axial dimensions correlated equally with tumor volume (correlation coefficient = 0.93). Surrogate measures based on the equations for a sphere and an ellipsoid underestimated tumor volume, whereas the equation for a cube overestimated volume.CONCLUSIONS When reporting tumor size, there is no significant added benefit in reporting bidimensional or tridimensional measurements over the maximum axial dimension. Cancer 2001;91:555–60. © 2001 American Cancer Society.
    Cancer 01/2001; 91(3):555 - 560. DOI:10.1002/1097-0142(20010201)91:3<555::AID-CNCR1034>3.0.CO;2-F · 4.90 Impact Factor
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    Cancer 02/2001; 91(3):585 - 591. DOI:10.1002/1097-0142(20010201)91:3<585::AID-CNCR1038>3.0.CO;2-0 · 4.90 Impact Factor
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