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Brain Tumor Volume Measurement: Comparison of Manual and Semiautomated Methods¹

¹ From the Departments of Radiology, Division of Neuroradiology (B.N.J., M.B.F., C.C.M., P.J.G.), Psychiatry (C.C.M.), Neurosurgery (M.E.B.), Neurology (M.E.B.), and Medicine (M.E.B.), and the Pittsburgh Cancer Institute (Q.H., R.S.D.), University of Pittsburgh Medical Center, Pittsburgh, Pa. Received May 29, 1998; revision requested July 22; revision received November 11; accepted March 29, 1999. Address reprint requests to M.B.F., Department of Radiology, Presbyterian University Hospital, Rm D-132, 200 Lothrop St, Pittsburgh, PA 15213-2582 (e-mail: fukuimb@radserv.arad.upmc.edu).

PURPOSE: To compare the reliability of two approaches to measuring enhancing brain tumor volumes—the conventional manual trace method and a threshold-based, semiautomated computer software method.

MATERIALS AND METHODS: Two operators rated contrast material–enhanced, T1-weighted axial magnetic resonance (MR) image data sets from 16 patients aged 21–71 years with high-grade gliomas. Each MR data set was rated twice by using manual tracing and twice by using the semiautomated method. The semiautomated measurement method involved a thresholding algorithm based on mixture modeling. The data collection time for each method was recorded. Reliability was measured by using inter- and intraoperator agreement indexes.

RESULTS: Mean intraoperator agreement indexes (± SD) were 0.90 ± 0.09 (operator 1) and 0.83 ± 0.15 (operator 2) for the manual trace method and 0.83 ± 0.17 (operator 1) and 0.84 ± 0.16 (operator 2) for the semiautomated measurement method. The mean interoperator agreement was 0.85 ± 0.14 for the manual method and 0.82 ± 0.18 for the semiautomated method. The semiautomated method was faster than the manual trace method by an average of 4.6 minutes per patient.

CONCLUSION: The semiautomated computer method of measuring tumor volume was faster than the manual trace method. Semiautomated computer approaches offer an alternative to manual tracing for measuring serial tumor volumes in patients with high-grade brain neoplasms.

Index terms: Brain neoplasms, 10.363, 10.3634 • Brain neoplasms, MR, 10.12141, 10.12143 • Magnetic resonance (MR), volume measurement, 10.12141, 10.12143 • Technology assessment

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