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Multicenter Study
. 2009 Aug;30(2):344-50.
doi: 10.1002/jmri.21847.

Measurements from image-based three dimensional pelvic floor reconstruction: a study of inter- and intraobserver reliability

Lennox Hoyte  1 , Linda Brubaker, Julia R Fielding, Mark E Lockhart, Marta E Heilbrun, Caryl G Salomon, Wen Ye, Morton B Brown; Pelvic Floor Disorders Network
Affiliations
Multicenter Study

Measurements from image-based three dimensional pelvic floor reconstruction: a study of inter- and intraobserver reliability

Lennox Hoyte et al. J Magn Reson Imaging. 2009 Aug.

Abstract

Purpose: To describe inter- and intraobserver reliability of 3D measurements of female pelvic floor structures.

Materials and 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.

Conclusion: 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.

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Figures

Figure 1
Figure 1
MRI 2D and 3D measurement of the intertuberous distance. Figure 1a shows the MRI 2D axial source image is shown at the level of the iscial tuberosities (Arrowheads). Figure 1b shows the 3D reconstructed image, with the black arrowheads indicating the iscial tuberosities. Color legend: White: pubic bones, yellow- urethra, pink – vagina, brown – Levator ani, rose- Obturator internus, gray – symphysis bubis and coccyx.
Figure 1
Figure 1
MRI 2D and 3D measurement of the intertuberous distance. Figure 1a shows the MRI 2D axial source image is shown at the level of the iscial tuberosities (Arrowheads). Figure 1b shows the 3D reconstructed image, with the black arrowheads indicating the iscial tuberosities. Color legend: White: pubic bones, yellow- urethra, pink – vagina, brown – Levator ani, rose- Obturator internus, gray – symphysis bubis and coccyx.
Figure 2
Figure 2
Intraclass correlations and SD ratio. The top plot is the ratio of the standard deviation (SD) between readers to the SD of the measurement. A short line indicates good reproducibility and a long line indicates poor reproducibility. The short lines correspond to high IntraClass Correlation (ICC). Levels below 0.4 are considered reliable, and those less than 0.6 are considered acceptable. The bottom panel is the intraclass correlation for each measured parameter. Values above the 0.7 level are considered acceptable, and those above 0.85 are considered reliable. Both levels are illustrated on the lower graph.
See this image and copyright information in PMC

References

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