title: Assessment of intra-observer variability in measurement of high-grade brain tumors.
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.
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA. Prove001@mc.duke.edu
authors.forename: James M
authors.initials: JM
authors.lastname: Provenzale
authors.forename: Michael C
authors.initials: MC
authors.lastname: Mancini
mesh_terms: D001921:Brain / Q000473:pathology*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D003952:Diagnostic Imaging; D006801:Humans; D060787:Neoplasm Grading; D015588:Observer Variation; D011379:Prognosis