Universität zu Köln

Hou, Xincen (2025). Reproducibility of Three-Dimensional Stereophotogrammetry in Measuring Periocular Tumor Area and Volume. PhD thesis, Universität zu Köln.

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Abstract

In this study, we utilized three-dimensional (3D) stereophotogrammetry to quantify the surface area of diverse tumors in the periocular region, assessing the reproducibility of these measurements. We collected 3D facial images from 150 patients diagnosed with periocular tumors. All tumors underwent classification according to their diameter, shape, color, location, surface texture, distance from the eyelid margin, clarity of boundaries, and histological characteristics. Following this, the surface area and volume of the tumor models were quantified, and intra-rater and inter-rater reproducibility was assessed. The results showed overall high reliability in area measurements, with intra-rater and inter-rater intraclass correlation coefficients (ICCs) of 0.998 and 0.974, respectively. The mean absolute difference (MAD) was 0.63 and 0.40 mm², and the relative measurement error (REM) was 1.94% and 1.22%, respectively. The technical error of measurement (TEM) was 2.29 and 7.81 mm², and the relative technical error of measurement (rTEM) was 6.95% and 23.76%, respectively. Four factors influencing reliability were identified: tumor diameter, color, location, and boundary clarity. Tumors with a diameter greater than 5 mm, brownish-black in color, located at the lateral canthus, upper eyelid, and lower eyelid, with clear margins, exhibited better reliability. For tumor volume measurement, the intra-rater and inter-rater ICC estimates were 0.974 and 0.907, indicating excellent reliability. The MAD for intra-rater and inter-rater measurements was below 2 mm3, specifically 1.44 mm3 and 1.41 mm3. The intra-rater TEM was 13.90 mm3, and the inter-rater TEM was 27.65 mm3. REM values were favorable, with 5.16% for intra-rater and 4.80% for inter-rater measurements. However, the rTEM values were relatively poor, at 49.53% for intra-rater and 93.76% for inter-rater measurements. Three factors influencing the reliability of tumor volume measurements were identified: tumor diameter, color, and location. For volume measurements, tumors with a diameter greater than 5 mm, located at the lateral canthus and upper eyelid, and brownish-black or red in color, showed higher reliability. In general, the reliability of tumor area measurements was superior to that of tumor volume measurements. This study is the first to conduct a comprehensive analysis with precise measurements of periocular tumor area and volume, providing reliable data on the accuracy of measurements for tumors in this region. These results are highly valuable for the clinical evaluation of periocular tumors. Surgical intervention remains the primary treatment for periocular tumors. The tumor area and volume play a critical role in determining the extent of preoperative skin excision, guiding the selection of the most suitable surgical approach, and assessing the prognosis, which is essential for the functional and aesthetic recovery of the eyelids post-surgery. Traditionally, clinical evaluations have mainly relied on measuring tumor diameter, which offers a limited assessment. Incorporating tumor area measurement into preoperative evaluations could greatly improve accuracy. Due to the complex periocular anatomy, small changes in tumor size can be difficult to detect visually. In these cases, stereophotogrammetry can be utilized for patient follow-up, facilitating the detection of subtle size changes and improving the planning of subsequent treatment strategies.

Item Type:	Thesis (PhD thesis)
Creators:	Creators Email ORCID ORCID Put Code Hou, Xincen xincen.hou@gmail.com UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-787408
Date:	2025
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Augenheilkunde > Klinik und Poliklinik für Allgemeine Augenheilkunde
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language three-dimensional anthropometry English periocular Tumor English Volume English Area English
Date of oral exam:	16 June 2025
Referee:	Name Academic Title Ludwig, Heindl Univ.-Prof. Dr. Dr. M.D., Ph.D., M.Sc Schick, Tina Privatdozentin Dr. med.
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/78740