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Medical Physics / Volume 38 / Issue 5 / RADIATION IMAGING PHYSICS

Med. Phys. 38, 2552 (2011); http://dx.doi.org/10.1118/1.3577602 (6 pages)

Tumor volume measurement errors of RECIST studied with ellipsoids

Zachary H. Levine

Optical Technology Division, National Institute of Standards and Technology, Gaithersburg, Maryland 20899-8441

Benjamin R. Galloway

Optical Technology Division, National Institute of Standards and Technology, Gaithersburg, Maryland 20899-8441 and Department of Engineering Physics, Colorado School of Mines, Golden, Colorado 80401-1887

Adele P. Peskin

Applied and Computational Mathematics Division, National Institute of Standards and Technology, Boulder, Colorado 80305-3328

Claus P. Heussel

Chest Clinic, University Hospital Heidelberg, Amalienstraße 5, 69126 Heidelberg, Germany

Joseph J. Chen

Department of Radiology, University of Maryland Medical Center, 22 South Greene Street, Baltimore, Maryland 21201-1595

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(Received 13 September 2010; accepted 22 March 2011; revised 22 March 2011; published online 5 May 2011)

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Purpose: The authors investigate the extent to which Response Evaluation Criteria in Solid Tumors (RECIST) can predict tumor volumes in ideal geometric settings and using clinical data.
Methods: The authors consider a hierarchy of models including uniaxial ellipsoids, general ellipsoids, and composites of ellipsoids, using both analytical and numerical techniques to show how well RECIST can predict tumor volumes in each case. The models have certain features that are compared to clinical data.
Results: The principal conclusion is that a change in the reported RECIST value needs to be a factor of at least 1.2 to achieve a 95% confidence that one ellipsoid is larger than another assuming the ratio of maximum to minimum diameters is no more than 2, an assumption that is reasonable for some classes of tumors. There is a significant probability that RECIST will select a tumor other than the largest due to orientation effects of nonspherical tumors: in previously reported malignoma data, RECIST would have selected a tumor other than the largest in 9% of the cases. Also, the widely used spherical model connecting RECIST values for a single tumor to volumes overestimates these volumes.
Conclusions: RECIST imposes a limit on the ability to determine tumor volumes, which is greater than the limit imposed by modern medical computed tomography machines. It is also likely the RECIST limit is above natural biological variability of stable lesions. The authors recommend the study of such natural variability as a fruitful avenue for further study.

© 2011 American Association of Physicists in Medicine

ACKNOWLEDGMENTS

BRG was supported by a Summer Undergraduate Research Fellowship at the National Institute of Standards and Technology. ZHL and Steven Grantham have a US Patent pending based on the work in Ref. 22.

Article Outline

  1. INTRODUCTION
  2. RECIST WITH ELLIPSOIDS
  3. DISCUSSION AND CONCLUSIONS
Digital Object Identifier
http://dx.doi.org/10.1118/1.3577602

KEYWORDS and PACS

Keywords

cancer, computerised tomography, medical diagnostic computing, numerical analysis, physiological models, tumours, volume measurement, x-ray imaging, RECIST, tumor size, volumetric measurement

PACS

PUBLICATION DATA

ISSN

0094-2405 (print)  

Publisher

$abstract.society.value is a Member of CrossRef American Association of Physicists in Medicine

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