Interobserver And Intraobserver Agreement In Parathyroid Scintigraphy: How Can Parathyroid Scintigraphy Be Made More Reliable?

Dalar, Cafer; Özdoğan, Özhan; Durak, Merih Güray; Koçdor, Mehmet Ali; Bekiş, Recep; Cayvarlı, Hakan; Kaya, Gamze Çapa; Çömlekçi, Abdurrahman; Degirmenci, Berna

doi:10.4158/ep11330.or

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…The average κ coefficient was 0.79 for accuracy and 0.70 for sensitivity. These results are comparable to previous results [12, 15]. …”

Section: Discussionsupporting

confidence: 92%

“…κ coefficients were used to quantify the agreement between the results from the four physicians. Positive kappa values within the ranges of 0.01–0.20, 0.21–0.4, 0.41–0.60, 0.61–0.80, and 0.81–1.00 were interpreted as “very weak,” “weak,” “medium,” “good,” and “very good” agreement, respectively [12]. A P value <0.05 was considered statistically significant.…”

Section: Methodsmentioning

confidence: 99%

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Comparison of Five Parathyroid Scintigraphic Protocols

Tunninen

Varjo

Schildt

et al. 2013

International Journal of Molecular Imaging

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Objectives. We compared five parathyroid scintigraphy protocols in patients with primary (pHPT) and secondary hyperparathyroidism (sHPT) and studied the interobserver agreement. The dual-tracer method (99mTc-sestamibi/123I) was used with three acquisition techniques (parallel-hole planar, pinhole planar, and SPECT/CT). The single-tracer method (99mTc-sestamibi) was used with two acquisition techniques (double-phase parallel-hole planar, and SPECT/CT). Thus five protocols were used, resulting in five sets of images. Materials and Methods. Image sets of 51 patients were retrospectively graded by four experienced nuclear medicine physicians. The final study group consisted of 24 patients (21 pHPT, 3 sHPT) who had been operated upon. Surgical and histopathologic findings were used as the standard of comparison. Results. Thirty abnormal parathyroid glands were found in 24 patients. The sensitivities of the dual-tracer method (76.7–80.0%) were similar (P = 1.0). The sensitivities of the single-tracer method (13.3–31.6%) were similar (P = 0.625). All differences in sensitivity between these two methods were statistically significant (P < 0.012). The interobserver agreement was good. Conclusion. This study indicates that any dual-tracer protocol with 99mTc-sestamibi and 123I is superior for enlarged parathyroid gland localization when compared with single-tracer protocols using 99mTc-sestamibi alone. The parathyroid scintigraphy was found to be independent of the reporter.

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“…The average κ coefficient was 0.79 for accuracy and 0.70 for sensitivity. These results are comparable to previous results [12, 15]. …”

Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Comparison of Five Parathyroid Scintigraphic Protocols

Tunninen

Varjo

Schildt

et al. 2013

International Journal of Molecular Imaging

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“…10 min) (Noltes et al 2019 ). In a study of parathyroid imaging using 99m Tc sestamibi, Dalar et al (Dalar et al 2012 ) found ‘good’ to ‘very good’ inter- and intra-observer agreement, which is also in accordance with our findings.…”

Section: Discussionsupporting

confidence: 92%

Locating hyperfunctioning parathyroid glands using 11C-Choline PET/CT: an inter- and intra-observer variation study

Christensen

Jensen

Søndergaard

et al. 2021

European J Hybrid Imaging

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Background Use of 11C-Choline PET/CT is gaining ground in detecting hyperfunctioning parathyroid glands in primary hyperparathyroidism. The purpose of this study was to evaluate the robustness of 11C-Choline PET/CT by assessing intra- and inter-observer agreement to determine whether the method was reader sensitive and therefore should only be performed at highly specialised sites with a high number of cases. PET/CT images of 40 patients diagnosed with primary hyperparathyroidism were anonymised and evaluated three times by three readers: an expert reader and two non-experts (non-experts were experienced in PET/CT imaging, but not in 11C-Choline PET/CT in the setting of primary hyperparathyroidism). Number of hyperfunctioning parathyroid glands, location relative to the thyroid gland and confidence of each assessment (low, moderate or high) were noted, and intra- and inter-observer agreement calculated using Fleiss’ kappa method. Sensitivities and specificities of the non-experts were calculated using the expert reader as gold standard. Results Intra-observer agreement was ‘good’ to ‘near perfect’ for all readers. Inter-observer agreement was good between non-experts and the expert, with kappa values ≥ 0.74. Sensitivities between non-experts and the expert were high, > 81%, when assessing which side and 75% when assessing thyroid quadrant. All specificities were > 94%. Reader certainties were ‘high’ in > 80% of cases for the expert and > 70% and > 65%, respectively for the two non-experts. Conclusion 11C-Choline PET/CT is not reader sensitive for the localisation of hyperfunctioning parathyroid glands and may therefore be safely implemented at sites that have a moderate number of cases. Access to a cyclotron laboratory is, however, a necessity for the production of 11C-Choline. The study was conducted in accordance with the Helsinki 2 declaration and The International Council for Harmonisation Guideline for Good Clinical Practice (ICH_GCP) clinical trial, approved by the Research Ethics Committee of the Capital Region of Denmark (Journal-nr.:H-18012490, date of approval: 18 June 2018) and the Danish Medicines Agency (EudraCT no. 2018-000726-63, date of approval: 6 June 2018). The GCP unit in Eastern Denmark has carried out regular monitoring of the trial according to GCP (ID: 2018-1050).

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Intraobserver and interobserver agreement for the interpretation of 68Ga–prostate-specific membrane antigen-I&T positron emission tomography/computed tomography imaging

Gültekin¹,

Yaylalı²,

Şengöz³

et al. 2019

Nuclear Medicine Communications

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Objectives The use of 68Ga–prostate-specific membrane antigen positron emission tomography/computed tomography is spreading due to its clinical benefits. In this study, we aim to determine the intra- and interobserver agreement levels of 68Ga– prostate-specific membrane antigen-I&T positron emission tomography/computed tomography according to molecular imaging tumor-lymph node-metastases reporting system. Materials and methods Eighty prostate cancer patients and underwent 68Ga– prostate-specific membrane antigen positron emission tomography/computed tomography were blindly evaluated twice by four nuclear medicine specialists at intervals of 4 weeks. The evaluations were performed according to molecular imaging tumour-lymph node-metastases (miTNM) classification. We used Cohen’s Kappa and Fleiss’ Kappa analysis to analyse intra- and interobserver agreements. Results When 68Ga–prostate-specific membrane antigen positron emission tomography/computed tomography findings were evaluated according to miTNM classification, the obtained kappa values were as follows. The intraobserver Cohen’s kappa coefficient was found to be 0.79 (substantial agreement), 0.93 (almost perfect agreement), and 0.94 (almost perfect agreement) for miT, miN, and miM, respectively. During interobserver evaluation between the four observers, the kappa coefficient was 0.52 (moderate agreement) for miT, 0.74 (substantial agreement) for miN, and 0.84 (almost perfect agreement) for miM. Conclusion There is no research on the intraobserver agreement analysis of 68Ga–prostate-specific membrane antigen positron emission tomography/computed tomography in the literature. Our findings are the first ones. The intraobserver agreement was almost perfect. Moreover, although 68Ga–prostate-specific membrane antigen I&T positron emission tomography/computed tomography had moderate interobserver evaluation compliance of the primary tumour, it had excellent interobserver agreement levels in local lymph node metastasis and distant metastasis evaluation.4012501255

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Interobserver And Intraobserver Agreement In Parathyroid Scintigraphy: How Can Parathyroid Scintigraphy Be Made More Reliable?

Cited by 3 publications

References 16 publications

Comparison of Five Parathyroid Scintigraphic Protocols

Comparison of Five Parathyroid Scintigraphic Protocols

Locating hyperfunctioning parathyroid glands using 11C-Choline PET/CT: an inter- and intra-observer variation study

Intraobserver and interobserver agreement for the interpretation of 68Ga–prostate-specific membrane antigen-I&T positron emission tomography/computed tomography imaging

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