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Eur J Cancer. 2016 Jan;53:5-15. doi: 10.1016/j.ejca.2015.10.014. Epub 2015 Dec 10.

Observer variability in RECIST-based tumour burden measurements: a meta-analysis.

Author information

1
Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, South Korea.
2
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
3
Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, South Korea; Cancer Research Institute, Seoul National University, South Korea.
4
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
5
Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: hahns@snu.ac.kr.

Abstract

BACKGROUND:

Response Evaluation Criteria in Solid Tumours (RECIST)-based tumour burden measurements involve observer variability, the extent of which ought to be determined.

METHODS:

A literature search identified studies on observer variability during manual measurements of tumour burdens via computed tomography according to the RECIST guideline. The 95% limit of agreement (LOA) values of relative measurement difference (RMD) were pooled using a random-effects model.

RESULTS:

Twelve studies were included. Pooled 95% LOAs of RMD in measuring unidimensional longest diameters of single lesions ranged from -22.1% (95% confidence interval [CI], -30.3% to -14.0%) to 25.4% (95% CI, 17.2% to 33.5%) between observers and -17.8% (95% CI, -23.6% to -11.9%) to 16.1% (95% CI, 10.1% to 21.8%) for a single observer. Pooled 95% LOAs of RMD in measuring the sum of multiple lesions ranged from -19.2% (95% CI, -23.7% to -14.9%) to 19.5% (95% CI, 15.2% to 23.9%) between observers, and -9.8% (95% CI, -19.0% to -0.3%) to 13.1% (95% CI, 3.6% to 22.6%) for a single observer. Pooled 95% LOA of RMD in calculating the interval change of tumour burden with a single lesion ranged from -31.3% (95% CI, -46.0% to -16.5%) to 30.3% (95% CI, 15.3% to 44.8%) between observers. Studies on calculating the interval change of tumour burden for a single observer or with multiple lesions were lacking.

CONCLUSION:

Interobserver RMD in measuring single tumour burden and calculating its interval change may exceed the 20% cut-off for progression. Variability decreased when tumour burden was measured by a single observer or assessed by the sum of multiple lesions.

KEYWORDS:

Measurement; Meta-analysis; Observer variation; Response Evaluation Criteria in Solid Tumours; Tumour burden

PMID:
26687017
DOI:
10.1016/j.ejca.2015.10.014
[Indexed for MEDLINE]

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