Comparison of multiplanar reformatted CT lung tumor measurements to axial tumor measurement alone: Impact on maximal tumor dimension and T stage Journal Article


Authors: Ridge, C. A.; Huang, J.; Cardoza, S.; Zabor, E. C.; Moskowitz, C. S.; Zakowski, M. F.; Ginsberg, M. S.
Article Title: Comparison of multiplanar reformatted CT lung tumor measurements to axial tumor measurement alone: Impact on maximal tumor dimension and T stage
Abstract: OBJECTIVE. The purpose of this study was to compare measurements of lung tumor size between axial and multiplanar reformatted CT images, as well as to establish whether the difference between these measurements leads to a change in T stage. MATERIALS AND METHODS. Patients with lung tumors who underwent chest CT up to 31 days before lung resection between December 2010 and March 2012 were included. Axial, sagittal, and coronal CT images were evaluated by two independent readers (1 and 2) who were blinded to clinical data. In 89 patients, lung tumors categorized as T1a (54%), T1b (19%), T2a (24%), or T2b (3%) were analyzed. The longest tumor diameter using multiplanar reformatted CT was compared and correlated with axial CT alone and pathologic T stage. Statistical analysis included a Wilcoxon rank sum test to evaluate differences between measurements, intraclass correlation coefficient (ICC), and kappa statistic to assess agreement. RESULTS. Prediction of T stage using axial CT alone compared with multiplanar reformatted CT agreed in 82% of patients for reader 1 (κ = 0.660 [95% CI, 0.531-0.789]) and 80% of patients for reader 2 (κ = 0.695 [95% CI, 0.572-0.818]). Prediction of T stage using multiplanar reformatted CT resulted in upstaging in 18% and 20% of patients (for readers 1 and 2, respectively). Interobserver agreement (ICC [95% CI]) was 0.900 (0.803-0.954) for axial, 0.874 (0.772-0.946) for sagittal, and 0.754 (0.556-0.921) for coronal planes. CONCLUSION. Radiologic measurement of lung tumor T stage was higher using multiplanar reformatted CT as compared with axial CT alone. When available, multiplanar reformatted CT should be used to measure tumor dimension and thus assign an accurate lung cancer T stage. © American Roentgen Ray Society.
Keywords: staging; lung neoplasms; diagnosis; ct; non-small cell lung carcinoma
Journal Title: American Journal of Roentgenology
Volume: 201
Issue: 5
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2013-11-01
Start Page: 959
End Page: 963
Language: English
DOI: 10.2214/ajr.12.10033
PROVIDER: scopus
PUBMED: 24147464
DOI/URL:
Notes: --- - "Export Date: 2 December 2013" - "CODEN: AJROA" - "Source: Scopus"
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MSK Authors
  1. Michelle S Ginsberg
    235 Ginsberg
  2. Chaya S. Moskowitz
    278 Moskowitz
  3. James Huang
    214 Huang
  4. Emily Craig Zabor
    172 Zabor
  5. Maureen F Zakowski
    289 Zakowski
  6. Carole Ann Ridge
    8 Ridge