Quantitative growth measurement of lesions in hepatic interval CT exams

Standard clinical radiological techniques for determining lesion volume changes in interval exams are, as far as we know, quantitatively non-descriptive or approximate at best. We investigate two new registration based methods that help sketch an improved quantitative picture of lesion volume changes in hepatic interval CT exams. The first method, Jacobian Integration, employs a constrained Thin Plate Spline warp to compute the deformation of the lesion of interest over the intervals. The resulting jacobian map of the deformation is integrated to yield the net lesion volume change. The technique is fast, accurate and requires no segmentation, but is sensitive to misregistration. The second scheme uses a Weighted Gray Value Difference image of two registered interval exams to estimate the change in lesion volume. A linear weighting and trimming curve is used to accurately account for the contribution of partial voxels. This technique is insensitive to slight misregistration and useful in analyzing simple lesions with uniform contrast or lesions with insufficient mutual information to allow the computation of an accurate warp. The methods are tested on both synthetic and in vivo liver lesions and results are evaluated against estimates obtained through careful manual segmentation of the lesions. Our findings so far have given us reason to believe that the estimators are reliable. Further experiments on numerous in vivo lesions will probably establish the improved efficacy of these methods in supporting earlier detection of new disease or conversion from stable to progressive disease in comparison to existing clinical estimation techniques.