Assessment of Volumetric versus Manual Measurement in Disseminated Testicular Cancer; No Difference in Assessment between Non-Radiologists and Genitourinary Radiologist

Abstract

BackgroundThe aim of this study was to assess the feasibility and reproducibility of semi-automatic volumetric measurement of retroperitoneal lymph node metastases in testicular cancer (TC) patients treated with chemotherapy versus the standardized manual measurements based on RECIST criteria.Methods21 TC patients with retroperitoneal lymph node metastases of testicular cancer were studied with a CT scan of chest and abdomen before and after cisplatin based chemotherapy. Three readers, a surgical resident, a radiological technician and a radiologist, assessed tumor response independently using computerized volumetric analysis with Vitrea software® and manual measurement according to RECIST criteria (version 1.1). Intra- and inter-rater variability were evaluated with intra class correlations and Bland-Altman analysis.ResultsAssessment of intra observer and inter observer variance proved non-significant in both measurement modalities. In particularly all intraclass correlation (ICC) values for the volumetric analysis were > .99 per observer and between observers. There was minimal bias in agreement for manual as well as volumetric analysis.ConclusionIn this study volumetric measurement using Vitrea software® appears to be a reliable, reproducible method to measure initial tumor volume of retroperitoneal lymph node metastases of testicular cancer after chemotherapy. Both measurement methods can be performed by experienced non-radiologists as well.

Reliability of 3 Strategies of Orbital Tumor Volume Measurement Using Phantom Modeling

“…This technique has been used as a “gold standard” to test against semi-automated segmenting in multiple volumetric studies and has been validated in volumetric assessment of testicular cancer metastases to lymph nodes. 15–18 The current study found that MS was the only strategy tested which demonstrated no significant difference between the average true and measured volumes irrespective of tumor shape. MS allowed for precise contouring of tumor borders but still had only moderate ICC between true and measured volume and moderate interobserver variability.…”

“…The SA strategy uses software tools to perform volumetric measurement by manually selecting lesions in the axial and coronal plane followed by linear interpolation to create a 3D view. 15 Observers then visually assess the segmentation and make adjustments if the contour of the lesion is unsatisfactory. After segmentation, the software automatically generates and displays a volume in milliliters.…”

Inter-observer variability influences the Lugano classification when restaging lymphoma

“…Other investigators have shown that computer-aided volumetric tumour assessment is a promising technique in improving inter-observer variability, both with detection and diagnosis of lesions. 24,25,26…”

Longitudinal medical imaging approaches for characterization of porcine cancer models

“…Automatic measurements allow for a more objective approach and can easily incorporate growth in multiple dimensions. Volumetric analysis has been explored to improve the assessment of tumor burden [39,42,45,[125][126][127].…”