BackgroundHepatocellular carcinoma is a primary tumor of the liver and involves
different treatment modalities according to the tumor stage. After local
therapies, the tumor evaluation is based on the mRECIST criteria, which
involves the measurement of the maximum diameter of the viable lesion. This
paper describes a computed methodology to measure through the contrasted
area of the lesions the maximum diameter of the tumor by a computational
algorithm.Methods63 computed tomography (CT) slices from 23 patients were assessed.
Non-contrasted liver and HCC typical nodules were evaluated, and a virtual
phantom was developed for this purpose. Optimization of the algorithm
detection and quantification was made using the virtual phantom. After that,
we compared the algorithm findings of maximum diameter of the target lesions
against radiologist measures.ResultsComputed results of the maximum diameter are in good agreement with the
results obtained by radiologist evaluation, indicating that the algorithm
was able to detect properly the tumor limits. A comparison of the estimated
maximum diameter by radiologist versus the algorithm revealed differences on
the order of 0.25 cm for large-sized tumors (diameter > 5
cm), whereas agreement lesser than 1.0 cm was found for small-sized
tumors.ConclusionsDifferences between algorithm and radiologist measures were accurate for
small-sized tumors with a trend to a small decrease for tumors greater than
5 cm. Therefore, traditional methods for measuring lesion diameter should be
complemented non-subjective measurement methods, which would allow a more
correct evaluation of the contrast-enhanced areas of HCC according to the
mRECIST criteria.