Variability in computed tomography diameter measurements of solid renal masses

Lorenzo P. Orton, Richard H. Cohan, Matthew S. Davenport, Robert A. Parker, Aishwarya Parameswaran, Elaine M. Caoili, Ravi K. Kaza, Isaac R. Francis, James H. Ellis, J. Stuart Wolf, Khaled Hafez

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)533-542
Number of pages10
JournalAbdominal Imaging
Issue number3
StatePublished - Jun 2014
Externally publishedYes


  • Computed tomography
  • Renal mass measurements
  • Solid renal mass

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology


Dive into the research topics of 'Variability in computed tomography diameter measurements of solid renal masses'. Together they form a unique fingerprint.

Cite this