Inherent variability of CT lung nodule measurements in vivo using semiautomated volumetric measurements.


Journal Article

OBJECTIVE: The objective of our study was to evaluate repeatability and reproducibility of lung nodule volume measurements using volumetric nodule-sizing software. MATERIALS AND METHODS: Fifty nodules, less than 20 mm in diameter, in 29 patients were scanned with 1.25-mm collimation using MDCT (time 1 = T1). During the same session, two additional scans, using identical technique, were obtained through each nodule (T2, T3). Three observers working independently then obtained volumetric measurements using a semiautomated volumetric nodule-sizing software package. Qualitative nodule characterization was also performed. The Bland-Altman method for assessing measurement agreement was used to calculate the 95% limits for agreement for nodule volumes at T1, T2, and T3. RESULTS: Automated nodule segmentation was successful in 438 (97%) of 450 measurements. Forty-three nodules were available for final evaluation. Twenty-six nodules had well-defined edges, and 17 had irregular or spiculated margins. Seventeen were freestanding, 16 were juxtapleural, and 10 were juxtavascular in location. Average nodule volume was 345.5 mm(3) (range, 49.3-1,434 mm(3)). The mean interobserver variability (repeatability) was 0.018% (SD = 0.73%), and the SD of the mean for the three contemporaneous scans (reproducibility) was 13.1% (confidence limits, +/- 25.6%). SD and confidence limits narrowed as volumes increased. CONCLUSION: Volumetric measurements show minimal interobserver variability (0.018%) but an interscan SEM of 13.1% (confidence limits, +/- 25.6%). Repeatability and reproducibility of volumetric measurements are better than those of linear measurements reported in the literature.

Full Text

Duke Authors

Cited Authors

  • Goodman, LR; Gulsun, M; Washington, L; Nagy, PG; Piacsek, KL

Published Date

  • April 2006

Published In

Volume / Issue

  • 186 / 4

Start / End Page

  • 989 - 994

PubMed ID

  • 16554568

Pubmed Central ID

  • 16554568

International Standard Serial Number (ISSN)

  • 0361-803X

Digital Object Identifier (DOI)

  • 10.2214/AJR.04.1821


  • eng

Conference Location

  • United States