Comparison Of Spleen Volumes Estimated Using Planimetry And Prolate Ellipsoid Methods On Mri In Myelofibrosis Patients

Background: Splenomegaly is one of the most characteristic features of myelofibrosis (MF) with significant impact on the quality of life of patients. About 10% of MF patients present with severely symptomatic splenomegaly at diagnosis; another 50% develop it within 4 years of diagnosis. Pharmaceutical drug trials aimed at treating myelofibrosis have assessment of spleen size as one of its key trial endpoints. While assessment of spleen size (volume) by palpation is routinely performed in the clinic, unfortunately, it is not a precise and reliable method, a key requirement in drug trials. Medical imaging methods such as magnetic resonance imaging (MRI) and computed tomography (CT) provide a non-invasive approach to assessment of spleen volume. Both modalities allow acquisition of cross sectional abdominal images and enable full anatomical coverage of the spleen. Due to radiation concerns, MRI is preferred over CT modality. There are two approaches for analyzing cross sectional images for estimation of spleen volume - the planimetry method, that involves delineating spleen contours on each spleen slice to estimate complete spleen volume and the prolate ellipsoid method, that approximates the spleen to an ellipsoid structure and estimates spleen volume by using the prolate ellipsoid method (described below). The prolate method is a simple and quick way to assess spleen size compared to the planimetry method. However, the former method provides an approximate estimate of spleen size. The goal of this study was to compare the prolate method with planimetry method for estimating spleen volume for use in pharmaceutical clinical trials.