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We propose a method of using a relatively low degree of freedom (DOF) warping to accurately measure the interval change of lesions having homogeneous contrast. The setting presented here presupposes the use of interval computed tomography (CT) liver exams. After a 3 × 24 DOF warping of the later examination to match the liver's pose in the earlier exam of the interval pair is performed, the lesion's volume change is estimated using the computed difference volume of the two data sets via a novel method that counts partial volume contributions and is insensitive to slight misregistration. A mathematically generated phantom is used to quantify accuracy in the presence of noise. We also quantify the accuracy of our CT liver registrations using microcoils implanted for chemotherapy. A probabilistic liver atlas is used to support automatic masking and liver-focused registration.