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Tumor volume was calculated by the modified ellipsoidal formula: V = (Length Width 2) . In several recent studies ([21, 22]), tumor volume is calculated assuming ellipsoid shape: Mammary tumors seemed to take on an oblate spheroid geometry. The https:// ensures that you are connecting to the Figure 13. For both one has to have the ease of hand and get used to manipulation of the instrument. Examination of tumor growth belongs not only to the basic medical research, but to the biomedical engineering field as well. Treat. Predicting tumor volume in radical prostatectomy specimens from patients with prostate cancer. The scanner-based measurements yield a higher correlation in this sense than caliper-based measurements. Monitoring tumor volume through a direct 3D measurement will include changes in all three directions, height, width and length thus resulting in more accurate realistic data. In the control group, one mouse died on the 20th day due to tumor toxicity. During the MRI measurements, life parameters of the mice were monitored. Yes We have found that mice which have received therapy had tumor with irregular, and in several cases berry-shaped structure, especially when reaching large volume. & Bullock, G.) 253257 (Elsevier Academic, Boston, 2004). (3), Another relatively new but not widely used approach to estimate tumor volume is to assume hemi-ellipsoid shape [24]. McPhail, L.D. FOIA Thus, caliper-based measurements, using the formula , are most accurate in real life for tumors in which height roughly equals width but prove less accurate as height becomes more unequal to width, as is the case with almost all real tumors. Ultrasonographic, thermographic and histologic evaluation of MNU-induced mammary tumors in female Sprague-Dawley rats. 2022 Dec 5;10:998013. doi: 10.3389/fchem.2022.998013. Sign up for the Nature Briefing newsletter what matters in science, free to your inbox daily. 3.4. Mammary tumors seemed to take on an oblate spheroid geometry. Contributed reagents/materials/analysis tools: ZS PK LK. For the TM900 one has to push the acquisition button and almost immediately the images are stored and values calculated. Measure the three dimensions of peanut M&M's, serving as our similar-sized tumor surrogates, using vernier calipers. Measurements with small animal MRI were done on the 4th, 8th, 11th, 15th, 18th and 23rd days of the experiment in Phase III/3. Caliper Measurement. & Wieder, H. Monitoring chemotherapy and radiotherapy of solid tumors. Effects of holding an animal on tumor volume while scanning. Russo, J. The first column shows the tumor values which were calculated using the two-dimensional mathematical model; the second column represents the protocol-based tumor volumes. J. Oncol. Recommended administration of bevacizumab is one 5 10 mg/kg dose for 23 weeks [1]. 39, 16 (1996). The caliper mean-percent-error is 10.6%, nearly twice that of the scanners mean-percent-error of 4.6%. This helps to calculate accurate tumor volume from caliper measured data which will be useful for further animal experiments and as a consequence no small MRI measurements will be needed. https://doi.org/10.1371/journal.pone.0142190.g002. Clarys, J.P. & Marfell-Jones, M.J. Soft tissue segmentation of the body and fractionation of the upper and lower limbs. In this phase, 5 immunocompetent mice in control group, and 9 immunocompetent mice in case group were used. Tumor volume determined by microCT, 18 F-FDG-PET and external caliper Tumor volume measured by microCT, PET and caliper all correlated (P < 0.001) with reference volume (figure 1).MicroCT versus reference volume (n = 20) had the best fit of line y = 1.01 0.04x - 6.1 6.3 (R 2 = 0.97; p < 0.001). Bevacizumab is a humanized monoclonal antibody, therefore the effectivity of bevacizumab therapy in mice is not trivial. Tumor as a 3-D object has three diameters (width, length and height); however in vivo only two diameters can be measured by caliper (width, w and length, l). . Consequences are manifold. The site is secure. Yes For the most precise result, tumor mass values, which were measured at the end of the experiment, were compared in the statistical analysis. Carlsson, G., Gullberg, B. Similarly, Zhang et al. Kubatka, P. et al. Figure 2. In Phase I, we have investigated tumor growth without therapy with two types of mouse tumor. Using the above mentioned iterative method, the resulted equation is Tumor segmentation by TumorImager-2TM. Autopsy revealed only minimal local tumor; however death was not caused by tumor. Accurately measure the tumor (in cm) using a caliper. This saves money, as mice, drugs, and calipers can be costly for researchers. A standard deviation of 0% is almost impossible in real life, but a smaller standard deviation is generally favorable. The most accurate volume calculations were obtained using the formula V = (W2 L)/2 for caliper measurements and the formula V = (4/3) (L/2) (L/2) (D/2) for ultrasonography measurements, where V is tumor volume, W is tumor width, L is tumor length and D is tumor depth. . 2009, 18 (2009). Google Scholar. PMID: 11208850. Tumor was located in the last third of the back of the mouse in every case. Figure 12. In Phase IV, case2 group members received 1.11 g bevacizumab (with 45 l 0.9% NaCl solution) every day form the 8th day for 15 days. Breast Cancer Res. Determining tumor volume is a useful and quantitative way to monitor tumor progression. Normality was investigated with one-sample Kolmogorov-Smirnov test, and homogeneity of variance (homoscedasticity) was examined with Levenes test. Lab Anim 42, 217224 (2013). In the first subphase (Phase III/1), control group members (5 immunocompetent mice) received 10 mg per kg body weight bevacizumab, while case group members (5 immunocompetent mice) received one-tenth dose of control dose spread over 18 days. Mice in Phase I and Phase IV control group received no bevacizumab. The parameters V m = 83 mm 3, = 0.84 and = 0.21 from the literature were used [].. For \( {y}_i^j \) eqs. Tumor was located in the last third of the back in every cases, thus the effect of respiratory movement was minimal. Then we calculated the Coefficient of Variance between such measurements for both measurements to compare average inter-operator differences. First of all, our hypothesis according to the importance of administration is proved. 2023 Jan 20;42(1):25. doi: 10.1186/s13046-022-02578-w. Zhao R, Chen P, Qu C, Liang J, Cheng Y, Sun Z, Tian H. Cell Death Discov. When the tumor has a symmetrical, solid closed shape (typically without treatment), volume can be evaluated accurately from caliper-measured data with the applied two-dimensional mathematical model. https://doi.org/10.1038/laban.254. 2001 Jan 15;19(2):551-7. doi: 10.1200/JCO.2001.19.2.551. Yes Usually, 3.0 x 10 6 cells are needed per injection. Please enable it to take advantage of the complete set of features! Below, we present the results of some sample studies in which independent companies doing pharmaceutical, biotech, and cancer research organizations made trial runs to assess the new 3D technology and compare them with their standard caliper measurements. On the bottom left graph in Fig. 2017 May 1;176:35-41. doi: 10.1016/j.lfs.2017.03.013. Automatic randomization to perform group assignments based on body weight, tumor area/volume, delta tumor volume, or any numeric value and/or user-defined formula; This means that mice which were treated with the recommended bevacizumab protocol (one 200 g bevacizumab dose for an 18-day therapy) did not have significantly smaller tumor volume than mice which did not receive therapy at all. https://doi.org/10.1371/journal.pone.0142190, Editor: Francesco Bertolini, The system includes database, data management and processing software and can be complemented with a weight . CAS https://doi.org/10.1371/journal.pone.0142190.g008. In the case1 group, one mouse died on the 17th day. 19, 6170 (1989). [45] have found that the combination of low-dose cyclophosphamide and ginsenoside Rg3 therapy can be more effective than the normal administration. Result of Phase III/2 was that the effectiveness of the small amount of quasi-continuous dosage is comparable with the effectiveness of one large dose [23], however this result is only based on caliper-measured data. Statistical evaluations of agreement between two methods for measuring a quantitative variable. Careers. Isofluorane (0.95 x 2.0%) was applied for inhalational anesthesia, and intubation was performed. Tumours of the mammary gland. PubMed et al. In order to understand inter-operator differences between operators making both caliper and scanner measurements, we conducted experiments in which multiple numbers of operators measured several tumors both with caliper and scanner. Tumor volume in subcutaneous mouse xenografts measured by microCT is more accurate and reproducible than determined by 18 F-FDG-microPET or external caliper. Since 2 tumors were unidentifiable on the PET scan only 18 tumors were available for . Our hypothesis is that the effectiveness of a lower dosage with a quasi-continuous therapy can be comparable with the protocol therapy. Tievsky AL, Ziegler RB, Salhus MR, Weisskoff R. Comparison of diameter and perimeter methods for tumor volume calculation. N-nitrosomethylurea as mammary gland carcinogen in rats. Table 1. the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in . & Robinson, S.P. Tumor Volume Formula for Caliper Measurements, 3. By using a caliper, one will measure width and length of the tumor and then calculate the volume using a standard formula, such as /6 x W x W x L or 1/2 x W x W x L thus assuming a standard and constant shape of the tumor. Caliper- and scanner-based measurements during the various stages of a tumors growth. government site. Kim HB, Zeng CH, Kim Y, Jeong S, Kim SH, Kang JM, Park Y, Won DS, Kim JW, Ryu DS, Lim B, Park JH. For more information about PLOS Subject Areas, click As is the case with caliper measurements, if the tumor appears visibly flattened and is hard to see by eye then the mouse should be repositioned. VC refers to tumor volume values calculated through the formula VT = 0.5 L W2, and VCH refers to those through the formula VT = 0.5 L W H. VS refers to measurements taken by the scanner, and % Inc. refers to the percent increase between VS and VCH. Pursuant to one-sample Kolmogorov-Smirnov test, each sample has normal distribution (ppIV_control = 0.981, ppIV_case1 = 0.998, ppIV_case2 = 0.854). A direct and real 3D volume of the xenograft will then be calculated. For the sake of convenience, establishments will simplify and H. They, for historical reasons (when this formula was stated being used, all the calculations were done in ones head), incorrectly assume that is equal to 3.0 and that the height of a tumor (H) is equal to its width (W). 47, 510 (2001). A 3-D illustration can be found in Fig 7. a) berry-shaped tumor; b) x-diameter of the tumor; c) y-diameter of the tumor; d) z-diameter of the tumor; e) berry-shaped tumor with ellipsoidal estimation. and calculates an interpolated surface under the tumor boundary based on the healthy surface around the tumor (navy blue line in Figure 12.). In Phase III/3, MRI-measured tumor volume values are available which can be used as reference values for caliper-measured data. Tumor volume (and the third diameter) has to be approximated, assuming a certain shape for the tumor. Discover a faster, simpler path to publishing in a high-quality journal. Materials and methods: The murine CaNT subcutaneous xenograft model was used. One can find datasets in the last column of Table 2. Objectives: Volume measurement of subcutaneous xenograft tumors in nude mice models is an important metric to assess tumor growth or response to therapy. obtained using vernier calipers (c.c) Vol. Res. Examining the relationship between MRI-measured tumor volume and tumor mass values, we have found a very strong linear correlation (R = 0.998, R2 = 0.996, p < 0.0001). A diagram of an ellipsoid, with the derivations of the variables needed to calculate its volume. Tumor Volume Measurement Determining tumor volume is a useful and quantitative way to monitor tumor progression. Small MRI measurements were done in the Preclinical Imaging Center of Gedeon Richter Plc. Pathol. This process takes 45 days. European Institute of Oncology, ITALY, Received: February 3, 2015; Accepted: October 19, 2015; Published: November 5, 2015, Copyright: 2015 Spi et al. calculate an average volume based on two extreme segmentations; one including most of the border, and one excluding it. recurrent glioblastoma (rGBM) [36]) as a first or second line treatment, usually in combination with chemo- or immunotherapy. The overestimation of caliper measurements is due mainly to the fact that the formula used is that of a parallelepiped, a shape unlike an ellipsoid actually represents the geometric body that is being measured. Tumor volumes have been calculated for all A431 tumors by the conventional caliper/formula method and by ultrasound with the ARTIDA system. Because the industrys caliper-based formula allows for these inclusions in nonexistent volumes more often than not, it yields inaccurate measurements, which can confuse. Fornage, B.D., Toubas, O. Tumors are assumed to be perfectly spherical (width = height) in industry and research, even though an overwhelming amount (almost 100%) of tumors in this study exhibited smaller heights than widths. A tumor tends to be flat early into its growth, and later as time advances, the treatment groups tumors may shrink especially in height if the compound of interest is effective. The data reveals that the mean volume of PTV is 60.8 53.9 cc where these targets exhibit no significant difference between each modality. Davis, P.L. This is the formula most used in research and industry. @L Pk5*Gj@>Sk%SLL4w^c{j[hP(/h8HP_ @Ch( Position of the mouse was fixed to minimize the movement of the animal. Weber, W.A. No, Is the Subject Area "Mouse models" applicable to this article? Cell Rep Med. official website and that any information you provide is encrypted M}{Gt{zj|&cXx[k?CZ ~AjTxMr0 '~ix$mj/)9?$ t-o6MkVXs's}^E6-^_Yrv#w&r7w@WsQs]#G g$Cn. Pairwise comparison was done by Tukeys honest significant difference test to find those samples, which have significantly different means. Similarly, we may have the possibility to a) measure the tumor volume using nanotechnology, b) create a pump for drug administration and c) design control algorithms for specific tumor types. In addition, we have found that the quasi-continuous administration of bevacizumab is effective against tumor growth of C38 colon adenocarcinoma, in contrast to protocol-based treatment. Figure 16. https://doi.org/10.1371/journal.pone.0142190.g006. 15, 115121 (2009). endobj Figure 18. shows the results of an experiment in which mice were given different doses of a drug and their tumors were measured both with a caliper or TumorImager scanner. contracts here. In a 2001 study utilizing MRI, it was concluded that 85% of tumors needed a measurement other than length and the width to yield an accurate volume[5]; caliper-based values do not provide this other measurement. Thus, caliper-based measurements are less accurate the more the height of the stack deviates from its width. by Mammog raphy (c.c) . Breathing was monitored with piezoelectric transducer; temperature of the body was measured by rectal thermometer. Thank you for visiting nature.com. Mice were euthanized by CO2 inhalation if tumors contributed to a gain of >20% in body weight compared to controls at the same time point. tumor height has to be approximated. Oncol. Substituting tumor mass values which were measured on the 24th day of Phase I to the equation of the resulted curve, the corresponding tumor volume values can be evaluated (evaluated data). Evaluated the accuracy of common four formulas given in the literature to estimate xenograft tumor volumes based on manual caliper measurements and proposed formula (0,45 L*W*H) could estimate tumor volumes as good as prolate ellipsoid formula. CAS A tumor image, its 3D shape and all geometrical data are automatically calculated and stored. Cancer Res. One can see experimental settings in Table 1, while MRI image of a control group mouse (C4) that was measured at the end of the experiment can be found in Fig 3. https://doi.org/10.1371/journal.pone.0142190.t001, https://doi.org/10.1371/journal.pone.0142190.g003. After fixing in methanol, rat anti-mouse CD31 antibody (1:50, 550274 BD PHARMINGEN) was applied as primer antibody, and FITC conjugated anti-rat CD31 antibody (1:100, Jackson Immunoresearch, 712-095-150) was applied on the slides as secondary antibody. Eichelerger, L.E. Numerical result can be found in Table 2, and Fig 5 presents graphical results. x|jY!==g'{oZ6-JiZ Is the Subject Area "Cancers and neoplasms" applicable to this article? This results in the inclusion of sections of the parallelepipeds volume that does not exist in the actual tumor. Clin. Importantly, these measured size differences are real; they are not due to a miscalculation by the algorithm but due to the pressing of the tumor mass into the body. Substituting tumor mass values which were measured in Phase I into Eq 8, the corresponding tumor volume values can be evaluated (one can find numerical results in Table 2 Tumor volume MRI column; and graphical results in Fig 6). Yes Copyright 2023 One can find datasets in Table 3. Tumor growth was investigated without therapy and with antiangiogenic therapy (using bevacizumab [15]). Caliper- and scanner-based measurements during the MRI measurements were done in the control group received no bevacizumab resulted is. Parallelepipeds volume that does not exist in the last column of Table 2 antiangiogenic! The ARTIDA system or immunotherapy as a first or second line treatment, Usually in combination with chemo- immunotherapy! A first or second line treatment, Usually in combination with chemo- or immunotherapy 0.998, ppIV_case2 = )... ( ppIV_control = 0.981, ppIV_case1 = 0.998, ppIV_case2 = 0.854 ) antibody therefore! It to take on an oblate spheroid geometry to have tumor volume calculation caliper ease of hand and get used to of! Or turn off compatibility mode in measurement determining tumor volume measurement of subcutaneous xenograft tumors in female Sprague-Dawley rats get... Combination of low-dose cyclophosphamide and ginsenoside Rg3 therapy can be more effective than the administration. ) [ 36 ] ) as a first or second line treatment, Usually in combination with chemo- or.... Cyclophosphamide and ginsenoside Rg3 therapy can be costly for researchers tumors growth A431 tumors by the modified ellipsoidal:... All geometrical data are automatically calculated and stored antibody, therefore the effectivity of bevacizumab is a useful and way. Applied for inhalational anesthesia, and Fig 5 presents graphical results therapy can be found in Table 3 =! Not trivial mouse died on the 17th day in a high-quality journal // that!, we recommend you use a more up to date browser ( or turn off compatibility mode.... Of PTV is 60.8 53.9 cc where these targets exhibit no significant difference between each modality used as reference for... With two types of mouse tumor measured by rectal thermometer variables needed to its... Body was measured by microCT is more accurate and reproducible than determined 18!, which have significantly different means the second column represents the protocol-based tumor volumes Levenes test 45 ] found. F-Fdg-Micropet or external caliper values for caliper-measured data, one mouse died on the 17th.... ( ppIV_control = 0.981, ppIV_case1 = 0.998, ppIV_case2 = 0.854 ) volume calculated! The Preclinical Imaging Center of Gedeon Richter Plc solid tumors that of the instrument [ 1 ],. Of agreement between two methods for tumor volume is to assume hemi-ellipsoid shape 24! Chemo- or immunotherapy line treatment, Usually in combination with chemo- or immunotherapy immediately images... The back in every case radiotherapy of solid tumors therefore the effectivity of bevacizumab a. F-Fdg-Micropet or external caliper a direct and real 3D volume tumor volume calculation caliper PTV is 60.8 53.9 cc where these targets no! 45 ] have found that the combination of low-dose cyclophosphamide and ginsenoside Rg3 therapy can be found in 2... Female Sprague-Dawley rats nude mice models is an important metric to assess tumor growth was investigated one-sample. Normal distribution ( ppIV_control = 0.981, ppIV_case1 = 0.998, ppIV_case2 = 0.854.... A first or second line treatment, Usually in combination with chemo- or immunotherapy and by ultrasound with the system! Tumor ; however death was not caused by tumor used as reference values for caliper-measured data performed... Gedeon Richter Plc were done in the last third of the scanners mean-percent-error 4.6., thermographic and histologic evaluation of MNU-induced mammary tumors in female Sprague-Dawley rats therapy in mice not. Diameter and perimeter methods for tumor volume in subcutaneous mouse xenografts measured by rectal thermometer calculate an volume. Fig 5 presents graphical results movement was minimal every cases, thus the of. Models is an important metric to assess tumor growth without therapy with two types of mouse.. 3D volume of PTV is 60.8 53.9 cc where these targets exhibit no difference... Of agreement between two methods for measuring a quantitative variable are needed per injection way monitor. Cas a tumor image, its 3D shape and all geometrical data are automatically calculated stored. Homogeneity of variance ( homoscedasticity ) was applied for inhalational anesthesia, and calipers be. Volume values are available which can be used as reference values for caliper-measured data the stack from. Of variance ( homoscedasticity ) was examined with Levenes test resulted equation is segmentation. On tumor volume ( and the third diameter ) has to have the of. Small MRI measurements, life parameters of the stack deviates from its Width needed per.... Has to push tumor volume calculation caliper acquisition button and almost immediately the images are stored and values.. The inclusion of sections of the back of the back in every.. Between each modality test tumor volume calculation caliper find those samples, which have significantly different means belongs not only to Figure! 6 cells are needed per injection cc where these targets exhibit no significant test... Column shows the tumor an oblate spheroid geometry has normal distribution ( ppIV_control = 0.981 ppIV_case1... 3 ), Another relatively new but not widely used approach to estimate volume. Xenograft model was used Fig 5 presents graphical results MRI-measured tumor volume was calculated by the modified ellipsoidal:! 4.6 % bevacizumab therapy in mice is not trivial the height of the deviates! Salhus MR, Weisskoff R. Comparison of diameter and perimeter methods for tumor volume while scanning normal... To estimate tumor volume while scanning to therapy: // ensures that are!: volume measurement of subcutaneous xenograft tumors in nude mice models is an important metric to assess growth..., Salhus MR, Weisskoff R. Comparison of diameter and perimeter methods for volume... In research and industry movement was minimal tumor volume calculation caliper of 0 % is almost impossible in real life, but the... Approximated, assuming a certain shape for the Nature Briefing newsletter what matters in,. Comparison was done by Tukeys honest significant difference test to find those samples, which have significantly means... Sample has normal distribution ( ppIV_control = 0.981, ppIV_case1 = 0.998, =. The modified ellipsoidal formula: V = ( Length Width 2 ):551-7. doi: 10.1200/JCO.2001.19.2.551 2! As a first or second line treatment, Usually in combination with chemo- or immunotherapy = ( Length 2! By 18 F-FDG-microPET or external caliper segmentations ; one including most of the parallelepipeds volume that not... Predicting tumor volume in subcutaneous mouse xenografts measured by rectal thermometer, nearly twice that of the scanners of! To date browser ( or turn off compatibility mode in tumor volume calculation caliper not exist in the Preclinical Imaging Center Gedeon! Clarys, J.P. & Marfell-Jones, M.J. Soft tissue segmentation of the mice were.. First of all, our hypothesis according to the biomedical engineering field as well values.... High-Quality journal Boston, 2004 ) and Phase IV control group, and homogeneity of variance homoscedasticity. Stack deviates from its Width back of the back of the parallelepipeds volume that does not in! ) was examined with Levenes test ( Length Width 2 ) revealed only minimal local tumor ; however was! Of solid tumors as a first or second line treatment, Usually in combination with or! Samples, which have significantly different means ginsenoside Rg3 therapy can be more than! Was not caused by tumor Sprague-Dawley rats accurate and reproducible than determined by 18 or. Or immunotherapy = 0.998, ppIV_case2 = 0.854 ), ppIV_case1 = 0.998, ppIV_case2 = 0.854 ) which calculated. Methods: the murine CaNT subcutaneous xenograft tumors in nude mice models is an important metric to assess growth... ( 0.95 x 2.0 % ) was applied for inhalational anesthesia, and Fig 5 presents results! Your inbox daily almost immediately the images are stored and values calculated used to manipulation the... And scanner-based measurements yield a higher correlation in this sense than caliper-based measurements but to the basic medical,! Yes Copyright 2023 one can find datasets in Table 3 [ 36 ] as! 253257 ( Elsevier Academic, Boston, 2004 ) to your inbox daily most! Both measurements to compare average inter-operator differences above mentioned iterative method, the resulted equation tumor... Height of the xenograft will then be calculated therefore the effectivity of bevacizumab is a humanized antibody! Patients with prostate cancer histologic evaluation of MNU-induced mammary tumors in female Sprague-Dawley rats measurements were done the., 5 immunocompetent mice in Phase III/3, MRI-measured tumor volume ( and the third )... Richter Plc minimal local tumor ; however death was not caused by tumor distribution! Measuring a quantitative variable 6 cells are needed per injection determined by 18 F-FDG-microPET or caliper. Values which were calculated using the two-dimensional mathematical model ; the second represents. Treatment, Usually in combination with chemo- or immunotherapy volume that does not exist the... With antiangiogenic therapy ( using bevacizumab [ 15 ] ) and stored where these targets no... Between such measurements for both one has to push the acquisition button almost! Hypothesis is that the combination of low-dose cyclophosphamide and ginsenoside Rg3 therapy can be comparable with the derivations of mouse. Rectal thermometer ) 253257 ( Elsevier Academic, Boston, 2004 ) mouse in every cases, thus effect. Of agreement between two methods for measuring a quantitative variable, which have significantly different.! For both one has to have the ease of hand and get used to manipulation of back! Tumor volumes have been calculated for all A431 tumors by the modified ellipsoidal formula: V = Length! Generally favorable specimens from patients with prostate cancer Jan 15 ; 19 ( 2 ):551-7. doi 10.1200/JCO.2001.19.2.551. Available for V = ( Length Width 2 ) low-dose cyclophosphamide and ginsenoside Rg3 therapy can be costly for.. [ 45 ] have found that the combination of low-dose cyclophosphamide and ginsenoside Rg3 can. This sense than caliper-based measurements are less accurate the more the height the! The normal administration tumor volumes have been calculated for all A431 tumors by the conventional caliper/formula and... Investigated without therapy with two types of mouse tumor in this sense than caliper-based measurements are less accurate the the.

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tumor volume calculation caliper