Verschure Derk O, Bongers Vivian, Hagen Petronella J, Somsen G Aernout, van Eck-Smit Berthe L F, Verberne Hein J
Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands,
J Nucl Cardiol. 2014 Jun;21(3):605-13. doi: 10.1007/s12350-014-9854-z. Epub 2014 Feb 4.
Purpose of this study was to assess the impact of mediastinal region of interest (ROI) definition on intra- and inter-observer variability in relation to collimator type.
Thirty-five subjects with CHF (80% men, mean age 66 ± 9 years, NYHA 2.4 ± 0.5, LVEF 29 ± 8.4%) were enrolled. 15 minutes and 4 hours post-injection (p.i.) of (123)I-MIBG, planar images were sequentially acquired with low energy high energy (LEHR) and medium energy (ME) collimators. In the first analysis, observer-defined mediastinal ROI was used. In the second analysis, a predefined mediastinal ROI was used. Intra- and inter-observer variability of late H/M was assessed using Lin's concordance coefficient (LCC).
There was substantial agreement between all three observers using predefined mediastinum ROI. LCCs for LEHR were 0.98, 0.96, and 0.95, for ME 0.98, 0.97, and 0.97. However, observer-defined mediastinal ROI resulted in poor-moderate agreement. LCCs for LEHR were 0.82, 0.94, and 0.70, for ME 0.77, 0.91, and 0.80. Intra-observer analysis using predefined mediastinal ROI showed substantial agreement. LCC was 0.97 for LEHR and 0.96 for ME.
Predefined mediastinal ROI results in low intra- and inter-observer variability of late H/M and is, therefore, to be preferred over observer-defined mediastinal ROI. Intra- and inter-observer variability of late H/M is not influenced by collimator choice.
本研究旨在评估感兴趣的纵隔区域(ROI)定义对与准直器类型相关的观察者内和观察者间变异性的影响。
招募了35名患有心力衰竭的受试者(80%为男性,平均年龄66±9岁,纽约心脏协会心功能分级2.4±0.5,左心室射血分数29±8.4%)。在注射(123)I-MIBG后15分钟和4小时,使用低能高分辨(LEHR)准直器和中能(ME)准直器依次采集平面图像。在第一次分析中,使用观察者定义的纵隔ROI。在第二次分析中,使用预定义的纵隔ROI。使用林氏一致性系数(LCC)评估晚期H/M的观察者内和观察者间变异性。
使用预定义的纵隔ROI时,所有三位观察者之间存在高度一致性。LEHR的LCC分别为0.98、0.96和0.95,ME的LCC分别为0.98、0.97和0.97。然而,观察者定义的纵隔ROI导致一致性为中等偏下。LEHR的LCC分别为0.82、0.94和0.70,ME的LCC分别为0.77、0.91和0.80。使用预定义的纵隔ROI进行的观察者内分析显示存在高度一致性。LEHR的LCC为0.97,ME的LCC为0.96。
预定义的纵隔ROI导致晚期H/M的观察者内和观察者间变异性较低,因此,优于观察者定义的纵隔ROI。晚期H/M的观察者内和观察者间变异性不受准直器选择的影响。