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Impressum
Inter- and intraobserver variability of tumor measurements using standardized echography
Haritoglou C., Herzum H., Neubauer A., Mueller A. J.
Department of Ophthalmology, Ludwig-Maximilians-University, Mathildenstr. 8, 80336 Munich, Germany
Objective: The knowledge about the accuracy of tumor measurements
using standardized echography is not only important for the choice of
treatment, but also for the long term follow up of tumor patients. This
prospective study was performed to describe the inter- and intraobserver
variations of tumor measurements.
Methods: 20 consecutive eyes of 20 consecutive patients with uveal
melanomas were examined in a masked mannor by three experienced examiners.
Measurements of tumor height and base diameter were obtained using routine
techniques for A- and B-scan ultrasound on four successive days. Data
was collected and analysed using SPSS 10.0 for Windows (SPSS Inc., Chicago,
IL, USA).
Results: The standard deviation over all examiners for tumor height
measurements was 0,18 mm (A-scan), 0,79 mm for transversal and 0,69 mm
for longitudenal base diameter (B-scan). Only small differences were noted
concerning the mean standard deviation between the three examiners (0,18
mm, 0,16 mm, 0,15 mm). The mean deviation of tumor height measurements
over different examiners decreased when several measurements were obtained
(0,3 mm after first to 0,10 mm after fourth measurement). The mean intraobserver
coefficient of variation was in the range of 20-35%.
Conclusion: Standardized echography is a helpfull and reliable
tool for the measurement of tumor height. As there are only small interobserver
variations of the measurements obtained, results achieved by different
examiners can be compared during the long term follow up of patients.
Tumor growth can be expected, when the difference between the measurements
is at least two standard deviations, in our study 0,18 mm.