title: Measurements from image-based three dimensional pelvic floor reconstruction: a study of inter- and intraobserver reliability.
abstract: OBJECTIVE
  To describe inter- and intraobserver reliability of 3D measurements of female pelvic floor structures.
  
  
  METHODS
  Twenty reconstructed MR datasets of primiparas at 6-12 months postpartum were analyzed. Pelvic organ measurements were independently made twice by three radiologists blinded to dataset order. A "within-reader" analysis, a "between-reader" analysis, and the intraclass correlation (ICC), and standard deviation ratio (SDR) were computed for each parameter. Fifteen continuous variables and one categorical variable were measured.
  
  
  RESULTS
  Eight continuous parameters showed excellent agreement (ICC >0.85 / SDR <0.40), five parameters showed relatively good agreement (ICC >0.70 / SDR >or=0.40, <0.60). Two parameters showed poor agreement (ICC <or=0.70 and/or SDR >or=0.60). The categorical variable showed poor agreement.
  
  
  CONCLUSIONS
  Agreement was best where landmark edges were well defined, acceptable where more "reader judgment" was needed, and poor where levator defects made landmarks difficult to identify. Automated measurement algorithms are under study and may improve agreement in the future.
authors.affiliation: University of South Florida, College of Medicine, Division of Urogynecology and Pelvic Reconstructive Surgery, Tampa General Hospital, Urogynecology Division, Tampa, Florida 33606-3508, USA. lennox@mindspring.com
authors.forename: Lennox
authors.initials: L
authors.lastname: Hoyte
authors.forename: Linda
authors.initials: L
authors.lastname: Brubaker
authors.forename: Julia R
authors.initials: JR
authors.lastname: Fielding
authors.forename: Mark E
authors.initials: ME
authors.lastname: Lockhart
authors.forename: Marta E
authors.initials: ME
authors.lastname: Heilbrun
authors.forename: Caryl G
authors.initials: CG
authors.lastname: Salomon
authors.forename: Wen
authors.initials: W
authors.lastname: Ye
authors.forename: Morton B
authors.initials: MB
authors.lastname: Brown
mesh_terms: D036861:Delivery, Obstetric / Q000009:adverse effects; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D017773:Pelvic Floor / Q000033:anatomy & histology*; D010387:Pelvimetry / Q000379:methods; D011446:Prospective Studies; D015203:Reproducibility of Results