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. 2008 Oct;90(1):57-61.
doi: 10.1007/s11060-008-9631-4. Epub 2008 Jun 28.

Inter-observer variability in the measurement of diffuse intrinsic pontine gliomas

Robert M Hayward  1 , Nicolas Patronas, Eva H Baker, Gilbert Vézina, Paul S Albert, Katherine E Warren
Affiliations

Inter-observer variability in the measurement of diffuse intrinsic pontine gliomas

Robert M Hayward et al. J Neurooncol. 2008 Oct.

Abstract

Diffuse intrinsic pontine glioma (DIPG) is an invasive pediatric brainstem tumor with a poor prognosis. Patients commonly enter investigational trials, many of which use radiographic response as an endpoint for assessing drug efficacy. However, DIPGs are difficult to measure on magnetic resonance imaging (MRI). In this study, we characterized the reproducibility of these commonly performed measurements. Each of four readers measured 50 MRI scans from DIPG patients and inter-observer variability was estimated with descriptive statistics. Results confirmed that there is wide variability in DIPG tumor measurements between readers for all image types. Measurements on FLAIR imaging were most consistent. For patients on clinical trials, measurement of DIPG should be performed by a single reader while comparing prior images side-by-side. Endpoints for clinical trials determining efficacy in this population should also include more objective measures, such as survival, and additional endpoints need to be investigated.

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Figures

Figure 1
Figure 1. MRI Examples
Figure 2
Figure 2. Measurement Procedure
The diagram depicts contiguous axial slices with the tumor in gray. d1 and d2 are the longest perpendicular diameters for the largest slice. d3 is determined by multiplying the number of slices involved by the slice thickness.
See this image and copyright information in PMC

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