Rationale and Objectives
To determine which methods of assessment of splenic size most accurately represent
the actual spleen volume in patients with Chronic Lymphocytic Leukemia (CLL).
Materials and Methods
The Abdominal Computed Tomography images of 48 patients with CLL enrolled on a phase
2 clinical trial at two time-points before and after 2-months of continuous acalabrutinib
treatment were analyzed. Linear one-dimensional measurements of the spleen were taken
in different planes. Two-dimensional and three-dimensional measurements were calculated
from the linear measurements using mathematical formulae. The spleen volume was determined
by manual segmentation as the ground truth. Data derived were analyzed using Pearson
correlation and statistical significance was set at p < 0.05.
Results
Among the single-dimensional measurements, the strongest correlation with the segmented
splenic volume was the sagittal long axis diameter (LAD) (r = 0.89, p < 0.05), followed closely by Coronal LAD (r = 0.87, p < 0.05) and cephalocaudal length (iwCLL) (r = 0.84, p < 0.05). For the two-dimensional indices, the sum of LAD and short axis diameter
(SAD) of the spleen in axial plane showed good correlation with the splenic volume
(r = 0.77, p < 0.05). Among the three-dimensional indices, the splenic index (0.523 x axial LAD
x axial SAD x coronal height) and a formula for volume (30 + 0.58 x axial LAD x axial
SAD x coronal height) had the strongest correlation (both r = 0.92, p < 0.05) with the spleen volume.
Conclusion
The three-dimensional formulae showed the strongest correlation with volumetric reference
spleen measurement. Among unidimensional measurements, the sagittal LAD had the best
correlation with the actual splenic volume. The two-dimensional calculation methods
were less reliable.
Key Words
Abbreviations:
BAp (Bland and Altman), CC (Coronal Cephalocaudal), CLL (Chronic Lymphocytic Leukemia), CT (Computed Tomography), iwCLL (International Workshop on Chronic Lymphocytic Leukemia), LAD (Long Axis Diameter), n (Normalized, PACS, Picture Archiving and Communication System), SAD (Short Axis Diameter)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 19, 2022
Accepted:
June 22,
2022
Received in revised form:
June 21,
2022
Received:
May 18,
2022
Identification
Copyright
Published by Elsevier Inc. on behalf of The Association of University Radiologists.
