title: Semiautomatic Analysis on Computed Tomography in Locally Advanced or Metastatic Non-Small Cell Lung Cancer: Reproducibility and Prognostic Significance of Unidimensional and 3-dimensional Measurements.
abstract: OBJECTIVE
  The aim of the study was to compare both reproducibility and prognostic value of lesion size measurements obtained manually and semiautomatically on computed tomography in advanced non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Manual axial longest diameter, semiautomatic axial longest diameter, and volume of NSCLC lesions were independently analyzed by 4 readers at baseline and after at least 1 cycle of platinum-based chemotherapy. The prognostic value of the proportional change in lesion size between baseline and follow-up CT was evaluated using either RECIST or experimental thresholds derived from the quartiles of the changes as assessed manually or semiautomatically.
  
  
  RESULTS
  Semiautomatic axial longest diameter (concordance correlation coefficient [CCC]: 0.980 to 0.987; variation coefficient [VC%]: 6% to 7.3%) and volume (CCC: 0.974 to 0.991; VC%: 5.6% to 9.5%) were more reproducible than manual axial longest diameter (CCC: 0.950 to 0.984; VC%: 6.4% to 11.7%). RECIST categories did not stratify patients with different survival durations. For 3/4 readers, a decrease of ≤ 70% in lesion volume was associated with shorter survival (median survival: 11 mo, P < 0.05; hazard ratio: 5 to 22.2, P < 0.05).
  
  
  CONCLUSIONS
  In advanced NSCLC, semiautomatic measures were more reproducible than manual diameter, and volumetric measurement may better predict patient survival.
authors.affiliation: *Section of Radiology, Department of Surgical Sciences, University Hospital of Parma †Section of Radiology, Diagnostic Department, Parma Hospital §Medical Oncology Unit, Emergency and Clinical Department, Parma Hospital, Parma ‡Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena, Forlì-Cesena, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Colombi
authors.forename: Carmelinda
authors.initials: C
authors.lastname: Manna
authors.forename: Ilaria
authors.initials: I
authors.lastname: Montermini
authors.forename: Valeria
authors.initials: V
authors.lastname: Seletti
authors.forename: Stefano
authors.initials: S
authors.lastname: Diciotti
authors.forename: Marcello
authors.initials: M
authors.lastname: Tiseo
authors.forename: Elisa
authors.initials: E
authors.lastname: Fontana
authors.forename: Massimo
authors.initials: M
authors.lastname: De Filippo
authors.forename: Mario
authors.initials: M
authors.lastname: Silva
authors.forename: Nicola
authors.initials: N
authors.lastname: Sverzellati
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007479:Iopamidol / Q000031:analogs & derivatives; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol