Ting-Ting Hu1, Ling Yan2, Peng-Fei Yan1, Xuan Wang1, Ge-Fen Yue3. 1. Department of Neurosurgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. 2. Department of Computer Science, University of Northern British Columbia, Prince George, Canada. 3. Department of Neurosurgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China gefen_yue@yahoo.com.
Abstract
BACKGROUND AND OBJECTIVE: Epidural hematoma volume (EDHV) is an independent predictor of prognosis in patients with epidural hematoma (EDH) and plays a central role in treatment decision making. This study's objective was to determine the accuracy and reliability of the widely used volume measurement method ABC/2 in estimating EDHV by comparing it to the computer-assisted planimetric method. METHODS: A data set of computerized tomography (CT) scans of 35 patients with EDH was evaluated to determine the accuracy of ABC/2 method, using computer-assisted planimetric technique to establish the reference criterion of EDHV for each patient. Another data set was constructed by randomly selecting 5 patients then replicating each case twice to yield 15 patients. Intra- and interobserver reliability were evaluated by asking four observers to independently estimate EDHV for the latter data set using the ABC/2 method. RESULTS: Estimation of EDHV using the ABC/2 method showed high intra- and interobserver reliability (intra-class correlation coefficient = .99). These estimates were closely correlated with planimetric measures (r = .99). But the ABC/2 method generally overestimated EDHV, especially in the nonellipsoid-like group. The difference between the ABC/2 measures and planimetric measures was statistically significant (p < .05). CONCLUSIONS: The ABC/2 method could be used for EDHV measurement, which would contribute to treatment decision making as well as clinical outcome prediction. However, clinicians should be aware that the ABC/2 method results in a general volume overestimation. Future studies focusing on justification of the technique to improve its accuracy would be of practical value.
BACKGROUND AND OBJECTIVE: Epidural hematoma volume (EDHV) is an independent predictor of prognosis in patients with epidural hematoma (EDH) and plays a central role in treatment decision making. This study's objective was to determine the accuracy and reliability of the widely used volume measurement method ABC/2 in estimating EDHV by comparing it to the computer-assisted planimetric method. METHODS: A data set of computerized tomography (CT) scans of 35 patients with EDH was evaluated to determine the accuracy of ABC/2 method, using computer-assisted planimetric technique to establish the reference criterion of EDHV for each patient. Another data set was constructed by randomly selecting 5 patients then replicating each case twice to yield 15 patients. Intra- and interobserver reliability were evaluated by asking four observers to independently estimate EDHV for the latter data set using the ABC/2 method. RESULTS: Estimation of EDHV using the ABC/2 method showed high intra- and interobserver reliability (intra-class correlation coefficient = .99). These estimates were closely correlated with planimetric measures (r = .99). But the ABC/2 method generally overestimated EDHV, especially in the nonellipsoid-like group. The difference between the ABC/2 measures and planimetric measures was statistically significant (p < .05). CONCLUSIONS: The ABC/2 method could be used for EDHV measurement, which would contribute to treatment decision making as well as clinical outcome prediction. However, clinicians should be aware that the ABC/2 method results in a general volume overestimation. Future studies focusing on justification of the technique to improve its accuracy would be of practical value.
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