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Assessment of intra-observer variability in measurement of high-grade brain tumors

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Abstract

A 25% increase in bidimensional products (BPs) of tumor diameter has been used as a criterion for brain tumor progression. We studied intra-observer variability in measurements of BPs. Ten patients with contrast-enhancing glioblastoma multiforme underwent baseline and follow-up MR imaging. Seven observers measured BPs in various planes. Differences in BPs between scans were expressed as a percentage of baseline. This calculation was performed for both readings of the baseline and follow-up scans. Differences between change from baseline to follow-up on each reading (termed D values) were calculated for each reader (total of 196 D values). Median D value in each plane was calculated for each reader. Range of D values was 12.36–33.64% in axial plane (average 10.63%), 12.18–38.62% in coronal plane (average 26.84%) and 15.12–35.48% in sagittal plane (average 26.11%). Across all planes, 88 (45%) D values were >25%. When all imaging planes for any single observation were combined, in 76% of cases, at least one D value of >25% was seen. Based on the high degree of intra-observer variability, tumor measurements producing an increase in BP of >25% can routinely be obtained solely by chance.

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Acknowledgments

The authors thank the following individuals for participating in the study: Timothy Amrhein MD, Erica Lee Berg MD, Courtney Coursey MD, Steven Huang MD, David Ihn MD, Ronaldo Lessa MD, and Basar Sarikaya MD.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Duke University Medical Center, Durham, NC, 27710, USA

    James M. Provenzale

  2. Department of Radiology, Oncology and Biomedical Engineering, Emory University School of Medicine, Atlanta, GA, 30322, USA

    James M. Provenzale

  3. Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA

    Michael C. Mancini

  4. Department of Biomedical Engineering, Emory University School of Medicine, Atlanta, GA, 30322, USA

    Michael C. Mancini

Authors
  1. James M. Provenzale
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  2. Michael C. Mancini
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Correspondence to James M. Provenzale.

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Provenzale, J.M., Mancini, M.C. Assessment of intra-observer variability in measurement of high-grade brain tumors. J Neurooncol 108, 477–483 (2012). https://doi.org/10.1007/s11060-012-0843-2

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  • DOI: https://doi.org/10.1007/s11060-012-0843-2

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