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Liver metastasis: comparison of 2 methods for reporting of disease in patients receiving chemotherapy
M Garant1, M Trudeau, C Reinhold
1Department of Diagnostic Radiology, Montreal General Hospital, McGill University, Que.
Objective:
To compare bidimensional measurements with direct volumetry in the reporting of disease in patients with liver metastases who are receiving chemotherapy.
Patients And 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.
Conclusion:
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.
