Evaluating variability in tumor measurements from same-day repeat CT scans of patients with non-small cell lung cancer Journal Article


Authors: Zhao, B.; James, L. P.; Moskowitz, C. S.; Guo, P.; Ginsberg, M. S.; Lefkowitz, R. A.; Qin, Y.; Riely, G. J.; Kris, M. G.; Schwartz, L. H.
Article Title: Evaluating variability in tumor measurements from same-day repeat CT scans of patients with non-small cell lung cancer
Abstract: Purpose: To evaluate the variability of tumor unidimensional, bidimensional, and volumetric measurements on same-day repeat computed tomographic (CT) scans in patients with non-small cell lung cancer. Materials and Methods: This HIPAA-compliant study was approved by the institutional review board, with informed patient consent. Thirty-two patients with non-small cell lung cancer, each of whom underwent two CT scans of the chest within 15 minutes by using the same imaging protocol, were included in this study. Three radiologists independently measured the two greatest diameters of each lesion on both scans and, during another session, measured the same tumors on the first scan. In a separate analysis, computer software was applied to assist in the calculation of the two greatest diameters and the volume of each lesion on both scans. Concordance correlation coefficients (CCCs) and Bland-Altman plots were used to assess the agreements between the measurements of the two repeat scans (reproducibility) and between the two repeat readings of the same scan (repeatability). Results: The reproducibility and repeatability of the three radiologists' measurements were high (all CCCs, ≥0.96). The reproducibility of the computer-aided measurements was even higher (all CCCs, 1.00). The 95% limits of agreements for the computer-aided unidimensional, bidimensional, and volumetric measurements on two repeat scans were (-7.3%, 6.2%), (-17.6%, 19.8%), and (-12.1%, 13.4%), respectively. Conclusion: Chest CT scans are well reproducible. Changes in unidimensional lesion size of 8% or greater exceed the measurement variability of the computer method and can be considered significant when estimating the outcome of therapy in a patient. © RSNA, 2009.
Keywords: adult; clinical article; aged; aged, 80 and over; middle aged; sensitivity and specificity; reproducibility; reproducibility of results; computer assisted tomography; observer variation; tumor volume; lung non small cell cancer; carcinoma, non-small-cell lung; lung neoplasms; tomography, x-ray computed; computer program; computer analysis; repeat procedure
Journal Title: Radiology
Volume: 252
Issue: 1
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2009-07-01
Start Page: 263
End Page: 272
Language: English
DOI: 10.1148/radiol.2522081593
PUBMED: 19561260
PROVIDER: scopus
PMCID: PMC2797680
DOI/URL:
Notes: --- - "Cited By (since 1996): 9" - "Export Date: 30 November 2010" - "CODEN: RADLA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Michelle S Ginsberg
    159 Ginsberg
  2. Lawrence H Schwartz
    281 Schwartz
  3. Leonard Philip James
    13 James
  4. Pingzhen Guo
    10 Guo
  5. Binsheng Zhao
    46 Zhao
  6. Chaya S. Moskowitz
    173 Moskowitz
  7. Gregory J Riely
    350 Riely
  8. Mark Kris
    612 Kris
  9. Yilin Qin
    2 Qin