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Variability in computed tomography diameter measurements of solid renal masses

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Abstract

Purpose

To determine whether the frequency of intra-observer measurement discrepancies ≥5 mm for solid renal masses varies by renal mass characteristics and CT contrast phase.

Materials and methods

This HIPAA-compliant retrospective study was approved by our IRB. We selected single CT images performed during the nephrographic phase (NP) of renal enhancement in 97 patients, each with a single solid renal mass. Mass location, margin, heterogeneity, and growth pattern were assessed. Six readers measured each mass on two occasions >3 weeks apart. Readers also measured the masses on images in 50 patients who had corticomedullary phase (CMP) images obtained during the same study. Results were assessed using Chi-square/Fisher’s exact and Wilcoxon Signed Rank tests, and logistic regression analyses.

Results

For NP to NP comparisons, intra-reader measurement differences ≥5 mm were seen for 3.7% (17/463) of masses <4 cm, but increased to 16.8% (20/119) for masses >4 cm (p < 0.0001). Masses with poorly defined margins (15.9% [22/138] vs. 3.4% [15/444] for well-defined margins, p < 0.0001) and heterogeneity (15.3% [22/144], vs. 5.0% [14/282] for minimally heterogeneous, vs. 0.6% [1/156] for homogeneous, p < 0.0001), were more frequently associated with measurement differences ≥5 mm. Differences ≥5 mm were more frequent when only CMP images were utilized (14% [42/299]), or when CMP images were compared with NP images (26% [77/299]).

Conclusions

A ≥5 mm intra-reader variation in measured size of solid renal masses <4 cm is uncommon for NP to NP comparisons. Variation increases when masses are ≥4 cm, poorly defined, or heterogeneous; or when CMP images are utilized.

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Authors and Affiliations

  1. Department of Radiology, University of Michigan Hospitals, 1500 East Medical Center Drive, Room B1D502G, Ann Arbor, MI, 48109-5030, USA

    Lorenzo P. Orton, Richard H. Cohan, Matthew S. Davenport, Aishwarya Parameswaran, Elaine M. Caoili, Ravi K. Kaza, Isaac R. Francis & James H. Ellis

  2. Directory of Biometry, Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, 02114, USA

    Robert A. Parker

  3. Department of Urology, University of Michigan Hospitals, Ann Arbor, MI, 48109-5030, USA

    J. Stuart Wolf & Khaled Hafez

Authors
  1. Lorenzo P. Orton
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  2. Richard H. Cohan
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  3. Matthew S. Davenport
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  4. Robert A. Parker
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  5. Aishwarya Parameswaran
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  6. Elaine M. Caoili
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  7. Ravi K. Kaza
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  8. Isaac R. Francis
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  9. James H. Ellis
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  10. J. Stuart Wolf
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  11. Khaled Hafez
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Corresponding author

Correspondence to Richard H. Cohan.

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Orton, L.P., Cohan, R.H., Davenport, M.S. et al. Variability in computed tomography diameter measurements of solid renal masses. Abdom Imaging 39, 533–542 (2014). https://doi.org/10.1007/s00261-014-0088-y

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  • DOI: https://doi.org/10.1007/s00261-014-0088-y

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