多针孔准直器可提高多巴胺转运体单光子发射计算机断层扫描中评估者内部和评估者之间的一致性以及视觉解读的确定性。

Multiple-pinhole collimators improve intra- and between-rater agreement and the certainty of the visual interpretation in dopamine transporter SPECT.

作者信息

Mathies Franziska, Apostolova Ivayla, Dierck Lena, Jacobi Janin, Kuen Katja, Sauer Markus, Schenk Michael, Klutmann Susanne, Forgács Attila, Buchert Ralph

机构信息

Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.

Scanomed Nuclear Medicine Centers, Debrecen, Hungary.

出版信息

EJNMMI Res. 2022 Aug 17;12(1):51. doi: 10.1186/s13550-022-00923-w.

DOI:10.1186/s13550-022-00923-w

PMID:35976493

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9385910/

Abstract

BACKGROUND

Multiple-pinhole (MPH) collimators improve the resolution-sensitivity trade-off compared to parallel-hole collimators. This study evaluated the impact of MPH collimators on intra- and between-rater agreement, and on the certainty of visual interpretation in dopamine transporter (DAT)-SPECT.

METHODS

The study included 71 patients (62.1 ± 12.7 y). Two SPECT acquisitions were performed in randomized order after a single injection of 182 ± 9 MBq I-FP-CIT, one with MPH and one with low-energy-high-resolution-high-sensitivity (LEHRHS) collimators. MPH projections were reconstructed with an iterative 3d Monte Carlo algorithm. LEHRHS projections were reconstructed with filtered backprojection (FBP) or with ordered-subsets expectation-maximization and resolution recovery (OSEM). Images were visually evaluated twice by three independent raters with respect to presence/absence of Parkinson-typical reduction of striatal I-FP-CIT uptake using a Likert 6-score (- 3 = clearly normal, …, 3 = clearly reduced). In case of intra-rater discrepancy, an intra-rater consensus was obtained. Intra- and between-rater agreement with respect to the Likert score (6-score and dichotomized score) was characterized by Cohen's kappa.

RESULTS

Intra-rater kappa of visual scoring of MPH/LEHRHS-OSEM/LEHRHS-FBP images was 0.84 ± 0.12/0.73 ± 0.06/0.73 ± 0.08 (6-score, mean of three raters) and 1.00 ± 0.00/0.96 ± 0.04/0.97 ± 0.03 (dichotomized score). Between-rater kappa of visual scoring (intra-rater consensus) of MPH/LEHRHS-OSEM/LEHRHS-FBP images was 0.70 ± 0.06/0.63 ± 0.08/0.48 ± 0.05 (6-score, mean of three pairs of raters) and 1.00 ± 0.00/0.92 ± 0.04/0.90 ± 0.06 (dichotomized score). There was a decrease of (negative) Likert scores in normal DAT-SPECT by 0.87 ± 0.18 points from the LEHRHS-OSEM to the MPH setting. The (positive) Likert scores of reduced DAT-SPECT did not change on average.

CONCLUSIONS

MPH collimators improve intra- and between-rater agreement as well as the certainty of the visual interpretation of DAT-SPECT.

摘要

背景

与平行孔准直器相比，多孔径（MPH）准直器改善了分辨率与灵敏度之间的权衡。本研究评估了MPH准直器对评分者内和评分者间一致性以及多巴胺转运体（DAT）-单光子发射计算机断层显像（SPECT）视觉解读确定性的影响。

方法

本研究纳入71例患者（62.1±12.7岁）。单次注射182±9MBq的I-FP-CIT后，以随机顺序进行两次SPECT采集，一次使用MPH准直器，一次使用低能高分辨率高灵敏度（LEHRHS）准直器。MPH投影采用迭代三维蒙特卡罗算法重建。LEHRHS投影采用滤波反投影（FBP）或有序子集期望最大化与分辨率恢复（OSEM）重建。由三名独立的评分者对图像进行两次视觉评估，使用李克特6分制（-3=明显正常，…，3=明显降低）评估纹状体I-FP-CIT摄取是否存在帕金森典型降低。如果评分者内存在差异，则达成评分者内共识。评分者内和评分者间关于李克特评分（6分制和二分制评分）的一致性用科恩kappa系数表示。

结果

MPH/LEHRHS-OSEM/LEHRHS-FBP图像视觉评分的评分者内kappa系数分别为0.84±0.12/0.73±0.06/0.73±0.08（6分制，三名评分者的平均值）和1.00±0.00/0.96±0.04/0.97±0.03（二分制评分）。MPH/LEHRHS-OSEM/LEHRHS-FBP图像视觉评分（评分者内共识）的评分者间kappa系数分别为0.70±0.06/0.63±0.0