N. Stocchetti et al., Mass volume measurement in severe head injury: accuracy and feasibility oftwo pragmatic methods, J NE NE PSY, 68(1), 2000, pp. 14-17
Objective-To assess the clinical feasibility and the accuracy of two pragma
tic methods in comparison with a conventional computer based method of meas
urement of masses from CT.
Methods-Nineteen CT scans of 11 patients with severe head injury, showing 3
4 traumatic lesions, were examined. The volume of every lesion was digitall
y measured, then a panel of three examiners independently repeated the meas
urement using the ellipsoid and the Cavalieri method in random order.
Results-All the lesions were identified by all the readers and the mean vol
ume measured by each examiner differed by less than 1.5 mi. The average rea
ding time for each scan was 4 minutes for the ellipsoid and 7 minutes for t
he Cavalieri method. The average volume of the lesions was 34.2 (SD 35) mi
with the digital system, and 38.4 (SD 41) mi and 34.8 (SD 36) ml for the el
lipsoid and the Cavalieri readings respectively. The average difference bet
ween the applied technique and the digital system was 0.57 (SD 9.99) mi for
the Cavalieri direct estimator and 0.20 (SD 15.48) mi for the ellipsoid me
thod. The 95% confidence interval for this difference fell between -2.75 an
d 3.89 ml for the Cavalieri, and between -4.94 and 5.35 ml for the ellipsoi
d method. There were 19 lesions >25 ml; the ellipsoid method identified 16
of them, whereas 17 were classified with the Cavalieri method. When conside
ring individual lesions rather than the average volume, discrepancies were
detected with both methods. The ellipsoid method was less precise, especial
ly when extracerebral lesions were measured.
Conclusions-Both pragmatic methods are inferior to computer based reading,
which is the choice when accurate volume estimation is necessary. However,
if a digital volumetric determination of the lesions using a CT computer is
not possible, the two pragmatic methods offer an alternative.