The validity and reliability of computed tomography orbital volume measurements

Orbital volume calculations allow surgeons to design patient-specific implants to correct volume deficits. It is estimated that changes as small as 1 ml in orbital volume can lead to enophthalmos. Awareness of the limitations of orbital volume computed tomography (CT) measurements is critical to differentiate between true volume differences and measurement error. The aim of this study is to analyze the validity and reliability of CT orbital volume measurements.

A total of 12 cadaver orbits were scanned using a standard CT maxillofacial protocol. Each orbit was dissected to isolate the extraocular muscles, fatty tissue, and globe. The empty bony orbital cavity was then filled with sculpting clay. The volumes of the muscle, fat, globe, and clay (i.e., bony orbital cavity) were then individually measured via water displacement. The CT-derived volumes, measured by manual segmentation, were compared to the direct measurements to determine validity.

The difference between CT orbital volume measurements and physically measured volumes is not negligible. Globe volumes have the highest agreement with 95% of differences between -0.5 and 0.5 ml, bony volumes are more likely to be overestimated with 95% of differences between -1.8 and 2.6 ml, whereas extraocular muscle volumes have poor validity and should be interpreted with caution.