Liver metastasis: comparison of 2 methods for reporting of disease in patients receiving chemotherapy.
OBJECTIVE
To compare bidimensional measurements with direct volumetry in the reporting of disease in patients with liver metastases who are receiving chemotherapy.


METHODS
Ten patients (6 men and 4 women) receiving chemotherapy were included. A total of 37 contrast-enhanced abdominal computed tomographic (CT) scans, forming 26 pairs of studies, were evaluated retrospectively by 2 independent reviewers. One reviewer recorded bidimensional measurements from hard-copy films, and the other recorded volumetric measurements at the CT console. All measurements were analysed before and after application of a 5% variation interval.


RESULTS
Reporting of disease was initially discordant in 5 (19%) of the 26 paired examinations. After application of a 5% variation interval, 9 cases (35%) were discordant. When borderline results (type of response modified by 5% variation) were excluded, 4 discordant cases (20%) remained. All but 1 case showed progressive disease with bidimensional measurements and no change at volumetry. The presence of a new lesion affected reporting in only 1 case.


CONCLUSIONS
The 2 methods of reporting disease are not interchangeable. We believe that volumetric measurements are more representative of tumour burden than bidimensional measurements. However, acquisition of nonhelical data may be a pitfall in volumetric measurements. The increasing availability of helical CT technology should resolve this issue.
Department of Diagnostic Radiology, Montreal General Hospital, McGill University, Que.
M
M
Garant
M
M
Trudeau
C
C
Reinhold
P M
PM
Bret
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003287:Contrast Media; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents; D003287:Contrast Media