Related Experiment Video
Updated: Jul 15, 2025
Quantifying Intermembrane Distances with Serial Image Dilations
Published on: September 28, 2018
Assessment of tympanic membrane perforation size using ImageJ software by ENT clinicians of different grades
Bhargavi Chandrasekar1, Kristijonas Milinis1, Natalie Lowe1
1ENT Department, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool, UK.
Insights
ImageJ software offers a more accurate method for measuring paediatric tympanic membrane perforations compared to visual estimation. This digital tool provides consistent results across clinicians of all experience levels, improving diagnostic precision.
Area of Science:
- Otolaryngology
- Medical Imaging
- Pediatric Medicine
Background:
- Accurate measurement of tympanic membrane perforations is crucial for appropriate clinical management in children.
- Visual estimation is commonly used but may lack precision.
- Digital tools offer potential for improved accuracy in otologic assessments.
Purpose of the Study:
- To compare the accuracy of visual estimation versus ImageJ software calculation for determining tympanic membrane perforation size in paediatric patients.
- To assess the impact of clinician experience on the accuracy of these measurement methods.
Main Methods:
- Five otoendoscopic images of paediatric tympanic membrane perforations were selected.
- Clinicians of varying experience (consultants, registrars, Senior House Officers) performed visual estimations and ImageJ calculations.
- ImageJ results from a consultant otologist served as the gold standard.
Main Results:
- ImageJ calculation demonstrated significantly higher accuracy than visual estimation, with a mean difference of 12.16% from the gold standard (p < 0.05).
- Registrars showed greater accuracy in visual estimation compared to Senior House Officers.
- No significant differences in ImageJ calculation accuracy were observed between different clinician experience levels.
Conclusions:
- ImageJ software provides a more accurate and reliable method for measuring tympanic membrane perforation size in children than traditional visual assessment.
- The accuracy of ImageJ measurements is independent of the clinician's experience level.
- This finding supports the adoption of ImageJ for standardized and precise evaluation of paediatric tympanic membrane perforations.
Objective:
To compare visual estimation versus ImageJ calculation of tympanic membrane perforation size in the paediatric population between clinicians of different experience.
Methods:
Five images of tympanic membrane perforations in children, captured using an otoendoscope, were selected. The gold standard was the ImageJ results by one consultant otologist. Consultants, registrars and Senior House Officers or equivalent were asked to visually estimate and calculate the perforation size using ImageJ software.
Results:
The mean difference in variation from gold standard between visual estimation and ImageJ calculation was 12.16 per cent, 95 per cent CI (10.55, 13.78) p < 0.05, with ImageJ providing a more accurate estimation of perforation. Registrars were significantly more accurate at visual estimation than senior house officers. There was no statistically significant difference in ImageJ results between the different grades.
Conclusion:
Using ImageJ software is more accurate at estimating tympanic membrane perforation size than visual assessment for all ENT clinicians regardless of experience.
