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Variability of quantitative measurements of metastatic liver lesions: a multi-radiation-dose-level and multi-reader comparison

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Abstract

Purpose

To evaluate the variability of quantitative measurements of metastatic liver lesions by using a multi-radiation-dose-level and multi-reader comparison.

Methods

Twenty-three study subjects (mean age, 60 years) with 39 liver lesions who underwent a single-energy dual-source contrast-enhanced staging CT between June 2015 and December 2015 were included. CT data were reconstructed with seven different radiation dose levels (ranging from 25 to 100%) on the basis of a single CT acquisition. Four radiologists independently performed manual tumor measurements and two radiologists performed semi-automated tumor measurements. Interobserver, intraobserver, and interdose sources of variability for longest diameter and volumetric measurements were estimated and compared using Wilcoxon rank-sum tests and intraclass correlation coefficients.

Results

Inter- and intraobserver variabilities for manual measurements of the longest diameter were higher compared to semi-automated measurements (p < 0.001 for overall). Inter- and intraobserver variabilities of volume measurements were higher compared to the longest diameter measurement (p < 0.001 for overall). Quantitative measurements were statistically different at < 50% radiation dose levels for semi-automated measurements of the longest diameter, and at 25% radiation dose level for volumetric measurements. The variability related to radiation dose was not significantly different from the inter- and intraobserver variability for the measurements of the longest diameter.

Conclusion

The variability related to radiation dose is comparable to the inter- and intraobserver variability for measurements of the longest diameter. Caution should be warranted in reducing radiation dose level below 50% of a conventional CT protocol due to the potentially detrimental impact on the assessment of lesion response in the liver.

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Data availability

The corresponding author has full control of the data.

Abbreviations

CI:

Confidence interval

ICC:

Intraclass correlation coefficient

SAFIRE:

Sinogram-affirmed iterative reconstruction

CTDIvol :

Volume CT dose index

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Funding

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Author information

Authors and Affiliations

  1. Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27710, USA

    Yuqin Ding, Daniele Marin, Rendon C. Nelson & Mathias Meyer

  2. Department of Radiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Medical Imaging, Shanghai, 200032, China

    Yuqin Ding

  3. Department ProMISE (Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties), University Hospital of Palermo, Piazza Delle Cliniche, 90127, Palermo, Italy

    Federica Vernuccio

  4. Department of Radiology, Clínica Alemana de Santiago, Universidad del Desarrollo, 8320000, Santiago, Chile

    Fernando Gonzalez

  5. Duke Cancer Institute-Biostatistics, Duke University Medical Center, Durham, NC, 27705, USA

    Hannah V. Williamson

  6. Department of Radiology, Stanford University, School of Medicine, Stanford, CA, 94305, USA

    Hans-Christoph Becker & Bhavik N. Patel

  7. The Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC, 27705, USA

    Justin Solomon & Ehsan Samei

  8. Siemens Healthineers, 40 Liberty Boulevard, Malvern, PA, 19355, USA

    Juan Carlos Ramirez-Giraldo

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Contributions

MM, DM,YD: Study concepts. MM, DM, JS, ES: Study design. MM, DM, FV, FG: Data acquisition. MM, DM, ES: Quality control of data and algorithms. MM, DM, FV, FG, HVW: Data analysis and interpretation. HVW: Statistical analysis. MM, DM, YD: Manuscript preparation. YD, MM, DM, FV, FG, HVW, HB, BNP, JS, ES, JCR, RCN: Manuscript editing. YD, MM, DM, FV, FG, HVW, HB, BNP, JS, ES, JCR, RCN: Manuscript review.

Corresponding author

Correspondence to Mathias Meyer.

Ethics declarations

Conflict of interest

One author of the study (J.C.R.G.) is an employee of Siemens Healthineers, two authors (D.M. and M.M.) received research support (provision of software tools used in this study) from Siemens Healthineers and MintLesion. All other authors are not employees of or consultants for the industry and had control of any data or information that might present a conflict of interest. No conflict of interest exits in the submission of this manuscript, and manuscript is approved by all authors for publication. All the authors listed have approved the manuscript that is enclosed.

Ethics approval

This study was approved by the institutional review board of Duke University and a waiver of written informed consent was obtained.

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Ding, Y., Marin, D., Vernuccio, F. et al. Variability of quantitative measurements of metastatic liver lesions: a multi-radiation-dose-level and multi-reader comparison. Abdom Radiol 46, 226–236 (2021). https://doi.org/10.1007/s00261-020-02601-8

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  • DOI: https://doi.org/10.1007/s00261-020-02601-8

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