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Effect of Varying CT Section Width on Volumetric Measurement of Lung Tumors and Application of Compensatory Equations¹

¹ From the Departments of Radiology (H.T.W.M., S.G.J., C.A.M., Y.L., A.M.A., R.D.T.) and Radiation Oncology (R.C.M.), Indiana University School of Medicine, Indianapolis. Received July 11, 2002; revision requested August 29; final revision received February 11, 2003; accepted March 3. Address correspondence to H.T.W.M., 11224 Clarkston Rd, Zionsville, IN 46077 (e-mail: hwinermu@iupui.edu).

PURPOSE: To determine how volume measurements of simulated and clinical lung tumors at standard computed tomographic (CT) lung window and level settings vary with section width and to derive and apply compensatory equations.

MATERIALS AND METHODS: Spherical simulated tumors of varying diameters were imaged with varying CT section widths, the images were displayed on a workstation, the cross-sectional area of the tumor on each section was measured by using elliptical and perimeter methods, and the areas were integrated to compute tumor volume. The actual and measured tumor volumes for differing section widths and tumor diameters were compared, and compensatory equations were derived. The equations were applied to contemporaneous chest CT images obtained in patients with stage I lung cancer, and the difference between thick- and thin-section–derived volumes before and after application of the equations was determined.

RESULTS: All simulated tumor volumes were overestimated 11%–278%; overestimation varied directly with section width and inversely with tumor diameter. With both measurement methods, mean thin-section volumes of clinical tumors in 55 patients were significantly smaller (P < .01) than mean thick-section volumes: Mean elliptical measurements were 15,025 mm³ (thin) and 18,037 mm³ (thick), with a 20.0% difference; mean perimeter measurements were 16,164 mm³ (thin) and 20,718 mm³ (thick), with a 22.2% difference. The thin-section–to–thick-section volume difference was larger for the smallest tumors. Thin-section volumes were smaller than thick-section volumes in 53 patients with the elliptical method and in 51 patients with the perimeter method. Applying the equations decreased the difference between thick- and thin-section volumes in 37 (67%) of the 55 patients with the elliptical method and in 41 (74%) patients with the perimeter method. The mean thin-section–to–thick-section volume difference became nonsignificant with the perimeter method but remained significant with the elliptical method.

CONCLUSION: Measured lung tumor volumes vary significantly with varying CT section width; overestimation varies directly with section width and inversely with tumor size. Compensatory equations that are somewhat effective in reducing these effects can be derived.

© RSNA, 2003

Index terms: Computed tomography (CT), experimental studies, 60.12111, 60.12115 • Lung neoplasms, 60.32 • Lung neoplasms, CT, 60.12111, 60.12115 • Thorax, CT, 60.12111, 60.12115

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