Department of Nuclear Medicine, University Hospital, Magdeburg, Germany.
Department of Nuclear Medicine, University Hospital, Frankfurt am Main, Germany.
Nuklearmedizin. 2024 Oct;63(5):294-299. doi: 10.1055/a-2344-6752. Epub 2024 Jul 17.
99mTc-Methoxy-Isobuty-Isonitrile (MIBI) imaging is used for risk stratifications of hypofunctioning thyroid nodules (TNs). MIBI uptake in the nodular tissue is compared to the uptake in the paranodular thyroid tissue. MIBI imaging may be interpreted visually and/or semi-quantitatively. This study aimed to evaluate the interobserver agreement (IOA) of different methods of interpreting MIBI imaging (visual and semi-quantitative approaches).
MIBI imaging data from 2018 to 2020 were collected. Four readers with varying work experience prospectively evaluated MIBI images (planar, SPECT/CT) visually and semi-quantitatively (Wash-Out Index (WOI)). After identifying the nodules on 99mTc-pertechnetate scintigram, the readers evaluated MIBI imaging data by using early, late, early-to-late, and SPECT late acquisitions. Region of interests (ROIs) were defined for semi-quantitative analysis and average counts were calculated using the WOI formula (by Campenni et al.) 1 2. IOA was assessed using Fleiss Kappa, Pearson correlation and Analysis of Variance (ANOVA).
23 patients with hypofunctioning nodules were included. Kappa analysis revealed an IOA of 0.57 for all readers for early imaging (moderate agreement); perfect matches were found in 57%. For late imaging, the IOA was 0.48 (moderate) for all, with perfect matches in 48%. The visual pattern (early-to-late) exhibited an IOA of 0.45 for all, with perfect matches in 57%. SPECT/CT evaluation showed an overall IOA of 0.44, with perfect matches in 48%. The semi-quantitative approach WOI yielded an overall result of 0.64 (good agreement) and perfect matches in 91%.
The IOA for WOI was higher than for visual methods. The WOI is independent of the reader's experience level. Visual analysis requires a certain level of experience from the reader.
99mTc-甲氧基异丁基异腈（MIBI）显像用于功能低下甲状腺结节（TNs）的风险分层。结节组织中的 MIBI 摄取与结节旁甲状腺组织中的摄取进行比较。MIBI 成像可以进行视觉和/或半定量解读。本研究旨在评估不同 MIBI 成像解读方法（视觉和半定量方法）的观察者间一致性（IOA）。
收集了 2018 年至 2020 年的 MIBI 成像数据。四位具有不同工作经验的观察者前瞻性地对 MIBI 图像（平面、SPECT/CT）进行视觉和半定量（洗脱指数（WOI））评估。在 99mTc-过锝酸盐闪烁显像上识别结节后，观察者通过早期、晚期、早期-晚期和 SPECT 晚期采集评估 MIBI 成像数据。为半定量分析定义了感兴趣区（ROI），并使用 Campenni 等人的 WOI 公式计算平均计数 1 2 。使用 Fleiss Kappa、Pearson 相关和方差分析（ANOVA）评估 IOA。
纳入了 23 例功能低下的结节患者。Kappa 分析显示，所有观察者的早期成像的 IOA 为 0.57（中度一致）；有 57%的完全匹配。对于晚期成像，所有观察者的 IOA 为 0.48（中度），有 48%的完全匹配。视觉模式（早期到晚期）的 IOA 为 0.45，完全匹配的比例为 57%。SPECT/CT 评估的整体 IOA 为 0.44，完全匹配的比例为 48%。半定量方法 WOI 的整体结果为 0.64（良好一致），完全匹配的比例为 91%。
WOI 的 IOA 高于视觉方法。WOI 独立于观察者的经验水平。视觉分析需要观察者具备一定的经验水平。
