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Dean E. Brenner, MD; Nancy O. Whitley, MD; Theodore L. Houk, PhD; Joseph Aisner, MD; Peter Wiernik, MD; Joseph Whitley, MD

JAMA. 1982;247(9):1299-1302.

Abstract
Modern computed tomographic (CT) scanners allow reasonably high-resolution cross-sectional visualization of most viscera and masses. To determine the accuracy of CT volume estimation, CT volumes of inanimate objects, cadaver kidneys and spleens, and in vivo balloons were performed. Regions of interest were outlined by a hand-operated cursor, and the computer program calculated the cross-sectional area in square millimeters and in pixels. A second computer program used Simpson's rule to calculate the volume from these multiple cross-sectional areas. Calculated CT volumes were within ±10% of directly measured volumes. Tumor masses being treated by chemotherapy were followed up clinically and by CT. Volume changes determined by CT are believed to be equal to and frequently more sensitive than clinical examination. From our experimental CT and clinical experiences, accuracy can be affected by (1) respiratory movement; (2) rapid changes in in vivo blood volume; (3) low CT number-gradient at the objects' periphery; (4) observer error in cursor tracing of the desired structure; and (5) mathematical errors inherent in Simpson's rule. We conclude that CT can estimate volumes of CT definable masses and can be useful in following tumor response to therapy.

(JAMA 1982;247:1299-1302)

Author Affiliations
From the Baltimore Cancer Research Center (Drs Brenner, Aisner, and Wiernik), and the Department of Diagnostic Radiology (Drs N. Whitley, Houk, and J. Whitley), University of Maryland Hospital, Baltimore. Dr Brenner is now with the Division of Oncology, Vanderbilt University, Nashville.

Footnotes
This material was presented in part at the Radiological Society of North America annual meetings in Dallas, Nov 14-21, 1980, and at the American Society of Clinical Oncology meetings, Washington, DC, April 30, 1981.

Reprint requests to the Department of Radiology, University of Maryland Hospital, 22 S Greene St, Baltimore, MD 21201 (Dr N. Whitley).

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