Assessing the effect of CT slice interval on unidimensional, bidimensional and volumetric measurements of solid tumours

Objectives: To study the magnitude of differences in tumour unidimensional (1D), bidimensional (2D) and volumetric (VOL) measurements determined from computed tomography (CT) images reconstructed at 5, 2.5 and 1.25 mm slice intervals. Materials and Methods: A total of 118 lesions in lung, liver and lymph nodes were selected from 30 patients enrolled in early phase clinical trials. Each CT scan was reconstructed at 5, 2.5 and 1.25 mm slice intervals during the image acquisition. Lesions were semi-automatically segmented on each interval image series and supervised by a radiologist. 1D, 2D and VOL were computed based on the final segmentation results. Average measurement differences across different slice intervals were obtained using linear mixed-effects analysis of variance models. Results: Lesion diameters ranged from 6.1 to 80.1 mm (median 18.4 mm). The largest difference was seen between 1.25 and 5 mm (mean difference of 7.6% for 1D [P < 0.0001], 13.1% for 2D [P < 0.0001], -5.7% for VOL [P = 0.0001]). Mean differences between 1.25 and 2.5 mm were all within +/- 3.5% (within +/- 6% confidence interval). For VOL, there was a larger average difference between measurements on different slice intervals for the smaller lesions (<= 10 mm) compared with the larger lesions. Conclusions: Different slice intervals may give different 1D, 2D and VOL measurements. In clinical practice, it would be prudent to use the same slice interval for consecutive measurements.