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Objectives <p>To investigate the influence of different tumor diameter measurement methods on the clinical T-staging of renal masses and compare this with the pathological T-staging.</p> Methods <p>Four two-dimensional (2D) and two three-dimensional (3D) measurement methods (2D axial, 2D perpendicular, 2D oblique, 2D ellipsoid*, 3D diameter* and 3D volume* (*newly proposed methods)) were used to calculate the tumor diameter in 173 patient cases. 3D models of the tumors were segmented on the preoperative computed tomography (CT) scans. PyRadiomics was used to automatically analyze the 3D models for the six different measurement methods. Paired t-tests were performed to compare the tumor diameter over the different methods. Operation time (OT) and estimated blood loss (EBL) were compared between the T1a and T1b tumors for all methods using unpaired t-tests.</p> Results <p>Maximal tumor diameter results depend on the measurement method. The 3D diameter method gave the highest value, on average 16.9% larger than the pathological diameter. The 3D volume method distinguished best between T1a and T1b with regard to OT and EBL, followed by the 2D axial method. The biggest limitations are the small number of large tumors included and the single-observer measurements.</p> Conclusion <p>The renal tumor diameter measured on imaging is influenced by the measurement technique and is larger than the pathological diameter. The newly proposed 3D volume method distinguishes surgical complexity best between T1a and T1b. However, when no 3D model is available, the simple diameter measurement on the axial plane could be sufficient.</p>

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Measurement of renal tumor size: the impact of 2D versus 3D methods on the T-stage

  • 期刊论文

  • 发表日期：

    2025年11月22日

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  • Saar Vermijs,
  • Joris Vangeneugden,
  • Pieter De Visschere,
  • Pieter De Backer,
  • Karel Decaestecker,
  • Charles Van Praet,
  • Charlotte Debbaut

摘要

Objectives

To investigate the influence of different tumor diameter measurement methods on the clinical T-staging of renal masses and compare this with the pathological T-staging.

Methods

Four two-dimensional (2D) and two three-dimensional (3D) measurement methods (2D axial, 2D perpendicular, 2D oblique, 2D ellipsoid*, 3D diameter* and 3D volume* (*newly proposed methods)) were used to calculate the tumor diameter in 173 patient cases. 3D models of the tumors were segmented on the preoperative computed tomography (CT) scans. PyRadiomics was used to automatically analyze the 3D models for the six different measurement methods. Paired t-tests were performed to compare the tumor diameter over the different methods. Operation time (OT) and estimated blood loss (EBL) were compared between the T1a and T1b tumors for all methods using unpaired t-tests.

Results

Maximal tumor diameter results depend on the measurement method. The 3D diameter method gave the highest value, on average 16.9% larger than the pathological diameter. The 3D volume method distinguished best between T1a and T1b with regard to OT and EBL, followed by the 2D axial method. The biggest limitations are the small number of large tumors included and the single-observer measurements.

Conclusion

The renal tumor diameter measured on imaging is influenced by the measurement technique and is larger than the pathological diameter. The newly proposed 3D volume method distinguishes surgical complexity best between T1a and T1b. However, when no 3D model is available, the simple diameter measurement on the axial plane could be sufficient.