title: Linear and volume measurements of pulmonary nodules at different CT dose levels - intrascan and interscan analysis.
abstract: OBJECTIVE
  To compare the interobserver variability of the unidimensional diameter and volume measurements of pulmonary nodules in an intrascan and interscan analysis using semi-automated segmentation software on ultra-low-dose computed tomography (ULD-CT) and standard dose CT (SD-CT) data.
  
  
  METHODS
  In 33 patients with pulmonary nodules, two chest multi-slice CT (MSCT) datasets (1 mm slice thickness; 20 % reconstruction overlap) had been consecutively acquired with an ultra-low dose (120 kV, 5 mAs) and standard dose technique (120 kV, 75 mAs). MSCT data was retrospectively analyzed using the segmentation software OncoTREAT (MeVis, Bremen, Germany, version 1.3). The volume of 229 solid pulmonary nodules included in the analysis as well as the largest diameter according to RECIST (Response Evaluation Criteria for Solid Tumors) were measured by two radiologists. Interobserver variability was calculated and SD-CT and ULD-CT data compared in an intrascan and interscan analysis.
  
  
  RESULTS
  The median nodule diameter (n = 229 nodules) was registered with 8.2 mm (range: 2.8 to 43.6 mm, mean: 10.8 mm). The nodule volume ranged between 0.01 and 49.1 ml (median 0.1 ml, mean 1.5 ml). With respect to interobserver variability, the intrascan analysis did not reveal statistically significant differences (p > 0.05) between ULD-CT and SD-CT with broader limits of agreement for relative differences of RECIST measurements (-31.0 % + 27.0 % mean -2.0 % for SD-CT; -27.0 % + 38.6 %, mean 5.8 % for ULD-CT) than for volume measurements (-9.4 %, 8.0 %, mean 0.7 % for SD-CT; -13 %, 13 %, mean 0.0 % for ULD-CT). The interscan analysis showed broadened 95 % confidence intervals for volume measurements (-26.5 % 29.1 % mean 1.3 %, and -25.2 %, 29.6 %, mean 2.2 %) but yielded comparable limits of agreement for RECIST measurements.
  
  
  CONCLUSIONS
  The variability of nodule volumetry assessed by semi-automated segmentation software as well as nodule size determination by RECIST appears to be independent of the acquisition dose in the CT source dataset. This is particularly important regarding size determination of pulmonary nodules in screening trials using low-dose CT data for follow-up imaging.
authors.affiliation: Institut für Radiologie, Charité Campus Mitte, Charité-Universitätsmedizin Berlin. patrick.hein@charite.de
authors.forename: P A
authors.initials: PA
authors.lastname: Hein
authors.forename: V C
authors.initials: VC
authors.lastname: Romano
authors.forename: P
authors.initials: P
authors.lastname: Rogalla
authors.forename: C
authors.initials: C
authors.lastname: Klessen
authors.forename: A
authors.initials: A
authors.lastname: Lembcke
authors.forename: V
authors.initials: V
authors.lastname: Dicken
authors.forename: L
authors.initials: L
authors.lastname: Bornemann
authors.forename: H-C
authors.initials: HC
authors.lastname: Bauknecht
mesh_terms: D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D003196:Computer Graphics; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D009367:Neoplasm Staging; D015588:Observer Variation; D011829:Radiation Dosage; D012189:Retrospective Studies; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D012680:Sensitivity and Specificity; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging; D012984:Software; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D036542:Tomography, Spiral Computed / Q000379:methods*