Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy.
Eur J Nucl Med Mol Imaging. 2013 Oct;40(10):1549-57. doi: 10.1007/s00259-013-2461-4. Epub 2013 Jun 6.
Imaging of the cardiac autonomic system with (123)I-metaiodobenzylguanidine (MIBG) is useful in the evaluation of patients with a variety of cardiac conditions, including heart failure (HF), but few data are available about the reproducibility of this technique. We assessed the observer reproducibility of the results from a low-dose (123)I-MIBG cardiac imaging protocol in patients with HF.
A total of 74 patients (62 men, age 67 ± 10 years) with HF and left ventricular systolic dysfunction (ejection fraction 31 ± 7 %) underwent low-dose (111 MBq) planar and single-photon emission computed tomography (SPECT) (123)I-MIBG cardiac sympathetic imaging. The intraclass coefficient of correlation (ICC), Lin's concordance correlation coefficient, and Bland-Altman analysis were used to evaluate the intraobserver and interobserver reproducibility of early and late heart-to-mediastinum (H/M) ratios and of defect scores on SPECT images. The κ statistic was used to evaluate the concordance rates for the identification of patients with a low H/M ratio (<1.60) on late planar imaging.
The differences between measurements obtained twice by the same examiner and by two examiners were negligible for both early and late H/M ratios and for SPECT defect scores. These findings were confirmed by the results of Bland-Altman analysis, and ICC and Lin's coefficient values were excellent (>0.90) for all measurements. For the identification of patients with a low H/M ratio, the κ values were 0.90 for intraobserver concordance and 0.83 for interobserver concordance.
The present study showed a high observer reproducibility of planar H/M ratios and SPECT defect scores using a low-dose (123)I-MIBG cardiac imaging protocol in patients with HF.
使用（123）I-间碘苄胍（MIBG）对心脏自主神经系统进行成像在评估各种心脏疾病患者（包括心力衰竭（HF））中很有用，但关于该技术的可重复性的数据很少。我们评估了低剂量（123）I-MIBG 心脏成像方案在 HF 患者中结果的观察者可重复性。
共有 74 名（62 名男性，年龄 67±10 岁）HF 和左心室收缩功能障碍（射血分数 31±7%）患者接受了低剂量（111MBq）平面和单光子发射计算机断层扫描（SPECT）（123）I-MIBG 心脏交感神经成像。使用组内相关系数（ICC）、Lin 一致性相关系数和 Bland-Altman 分析评估观察者内和观察者间早期和晚期心脏与纵隔（H/M）比值以及 SPECT 图像上缺陷评分的可重复性。使用 κ 统计评估对通过晚期平面成像识别 H/M 比值低（<1.60）的患者的一致性率。
同一检查者两次测量之间以及两名检查者之间的差异对于早期和晚期 H/M 比值以及 SPECT 缺陷评分均可以忽略不计。Bland-Altman 分析的结果证实了这一点，所有测量的 ICC 和 Lin 系数值均很高（>0.90）。对于识别 H/M 比值低的患者，观察者内一致性的 κ 值为 0.90，观察者间一致性的 κ 值为 0.83。
本研究表明，在 HF 患者中使用低剂量（123）I-MIBG 心脏成像方案，平面 H/M 比值和 SPECT 缺陷评分具有很高的观察者可重复性。
