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Three-dimensional quantitation of pediatric tumor bulk
K D Eggli1, P Close, P W Dillon
1Department of Radiology, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033, USA.
Pediatric Radiology
|January 1, 1995
Summary
Three-dimensional (3-D) volumetric analysis offers a more accurate assessment of pediatric tumor bulk and response to chemotherapy compared to standard two-dimensional (2-D) methods. This improved accuracy in measuring tumor size changes is crucial for effective therapeutic decisions in pediatric oncology.
Area of Science:
- Radiology
- Pediatric Oncology
- Medical Imaging Analysis
Background:
- Accurate assessment of tumor response to chemotherapy is vital for treatment decisions in pediatric oncology.
- Current methods rely on sequential measurements of tumor bulk and percent change, which may lack precision.
- Two-dimensional (2-D) volume calculations are commonly used but their accuracy in representing actual tumor size is questioned.
Purpose of the Study:
- To evaluate if three-dimensional (3-D) volumetric determination enhances the accuracy of assessing tumor response to therapy in pediatric oncology.
- To compare the accuracy of 3-D volumetric analysis with standard 2-D volume calculations for pediatric neoplasia.
- To determine the impact of using 3-D volumetric analysis on the categorization of tumor response.
Main Methods:
- Retrospective analysis of 45 CT scans from pediatric patients with unresectable thoracic or abdominal neoplasia.
- Tumor bulk was assessed using both standard 2-D volume formula (cross-sectional area x length) and 3-D volumetric analysis.
- Percent change in tumor size was calculated for 32 follow-up examinations, comparing 2-D and 3-D methods.
Main Results:
- The 2-D volume calculation overestimated tumor volume by over 50% in most examinations compared to 3-D analysis.
- In 28% of follow-up scans, the 2-D calculation of percent change in tumor size differed by more than 10% from the 3-D volume.
- In 15% of cases, the difference exceeded 25%, altering one patient's response category from 'no response' to 'partial response'.
Conclusions:
- Three-dimensional (3-D) volumetric analysis provides a more accurate assessment of actual tumor bulk in pediatric patients.
- This method offers a more precise evaluation of tumor size changes in response to therapy.
- 3-D volumetric analysis, easily performed by trained technologists, is recommended for improved accuracy in monitoring pediatric cancer treatment response.