We appreciate the comments of Drs Rubin and Phillips. Measurement of adrenal volumes with an imaging technique is difficult as the adrenal glands have a convoluted structure. The width of the gland is difficult to assess as each of the limbs is narrow and slight differences in assessment of this width are multiplied by the length of the gland. For this reason, visual assessment may be as accurate as a volumetric determination.
Volumetric assessment is a function of the spatial resolution of the imaging equipment used. Presumably, results obtained with the latest equipment as was done in our study (GE 9800 scanner, General Electric, Milwaukee, Wis) would be more accurate than those obtained on older scanners (Picker 1200, Cleveland, Ohio) as conducted in the study by Rubin and Phillips. The point of our study, however, was not to quibble over the method used, but to use the same technique to