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International Journal of Biomedical Imaging
Volume 2011, Article ID 361589, 11 pages
Research Article

X-Ray Computed Tomography: Semiautomated Volumetric Analysis of Late-Stage Lung Tumors as a Basis for Response Assessments

1DECS, AstraZeneca, 50S27 Mereside, Alderley Park, Macclesfield, Cheshire SK10 4TG, UK
2Definiens AG, Trappentreustraße 1, 80339 München, Germany
3Department of Imaging, Merck Research Laboratories, 770 Sumneytown Pike, WP42-305, West Point, PA 19486-0004, USA

Received 19 December 2010; Accepted 17 March 2011

Academic Editor: Yu Zou

Copyright © 2011 C. Bendtsen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. This study presents a semiautomated approach for volumetric analysis of lung tumors and evaluates the feasibility of using volumes as an alternative to line lengths as a basis for response evaluation criteria in solid tumors (RECIST). The overall goal for the implementation was to accurately, precisely, and efficiently enable the analyses of lesions in the lung under the guidance of an operator. Methods. An anthropomorphic phantom with embedded model masses and 71 time points in 10 clinical cases with advanced lung cancer was analyzed using a semi-automated workflow. The implementation was done using the Cognition Network Technology. Results. Analysis of the phantom showed an average accuracy of 97%. The analyses of the clinical cases showed both intra- and interreader variabilities of approximately 5% on average with an upper 95% confidence interval of 14% and 19%, respectively. Compared to line lengths, the use of volumes clearly shows enhanced sensitivity with respect to determining response to therapy. Conclusions. It is feasible to perform volumetric analysis efficiently with high accuracy and low variability, even in patients with late-stage cancer who have complex lesions.