Delcroix Olivier, Robin Philippe, Gouillou Maelenn, Le Duc-Pennec Alexandra, Alavi Zarrin, Le Roux Pierre-Yves, Abgral Ronan, Salaun Pierre-Yves, Bourhis David, Querellou Solène
Nuclear Medicine Department, CHRU Hospital Morvan, Brest, France.
Service de Médecine Nucléaire, EA 3878 GETBO IFR 148, Brest, France.
EJNMMI Res. 2018 Feb 12;8(1):14. doi: 10.1186/s13550-018-0367-7.
xSPECT Bone® (xB) is a new reconstruction algorithm developed by Siemens® in bone hybrid imaging (SPECT/CT). A CT-based tissue segmentation is incorporated into SPECT reconstruction to provide SPECT images with bone anatomy appearance. The objectives of this study were to assess xB/CT reconstruction diagnostic reliability and accuracy in comparison with Flash 3D® (F3D)/CT in clinical routine. Two hundred thirteen consecutive patients referred to the Brest Nuclear Medicine Department for non-oncological bone diseases were evaluated retrospectively. Two hundred seven SPECT/CT were included. All SPECT/CT were independently interpreted by two nuclear medicine physicians (a junior and a senior expert) with xB/CT then with F3D/CT three months later. Inter-observer agreement (IOA) and diagnostic confidence were determined using McNemar test, and unweighted Kappa coefficient. The study objectives were then re-assessed for validation through > 18 months of clinical and paraclinical follow-up.
No statistically significant differences between IOA and IOA F3D were found (p = 0.532). Agreement for xB after categorical classification of the diagnoses was high (κ = 0.89 [95% CI 0.84 -0.93]) but without statistically significant difference F3D (κ = 0.90 [95% CI 0.86 - 0.94]). Thirty-one (14.9%) inter-reconstruction diagnostic discrepancies were observed of which 21 (10.1%) were classified as major. The follow-up confirmed the diagnosis of F3D in 10 cases, xB in 6 cases and was non-contributory in 5 cases.
xB reconstruction algorithm was found reliable, providing high interobserver agreement and similar diagnostic confidence to F3D reconstruction in clinical routine.
xSPECT Bone®（xB）是西门子公司开发的一种用于骨混合成像（SPECT/CT）的新型重建算法。基于CT的组织分割被纳入SPECT重建，以提供具有骨骼解剖外观的SPECT图像。本研究的目的是在临床常规中评估xB/CT重建与Flash 3D®（F3D）/CT相比的诊断可靠性和准确性。对连续转诊至布雷斯特核医学科的213例非肿瘤性骨病患者进行了回顾性评估。纳入了207例SPECT/CT。所有SPECT/CT均由两名核医学医师（一名初级专家和一名高级专家）独立解读，先采用xB/CT，三个月后再采用F3D/CT。使用McNemar检验和非加权Kappa系数确定观察者间一致性（IOA）和诊断置信度。然后通过超过18个月的临床和辅助检查随访重新评估研究目标以进行验证。
未发现IOA与F3D的IOA之间存在统计学显著差异（p = 0.532）。诊断分类后xB的一致性较高（κ = 0.89 [95% CI 0.84 - 0.93]），但与F3D无统计学显著差异（κ = 0.90 [95% CI 0.86 - 0.94]）。观察到31例（14.9%）重建间诊断差异，其中21例（10.1%）被归类为主要差异。随访证实F3D诊断10例，xB诊断6例，5例无诊断贡献。
发现xB重建算法可靠，在临床常规中提供了较高的观察者间一致性和与F3D重建相似的诊断置信度。
