Visual and Semiquantitative Accuracy in Clinical Baseline 123I-Ioflupane SPECT/CT Imaging. (January 2019)

• Record Type: Journal Article
• Authors: Werner, Rudolf A.; Marcus, Charles; Sheikhbahaei, Sara; Solnes, Lilja B.; Leal, Jeffrey P.; Du, Yong; Rowe, Steven P.; Higuchi, Takahiro; Buck, Andreas K.; Lapa, Constantin; Javadi, Mehrbod S.
• Is Part Of: Clinical nuclear medicine. Volume 44:Number 1(2019)
• Publication Date: 2019-01
• Subjects: Parkinson disease -- parkinsonism -- DaTscan -- 123I-ioflupane -- SPECT -- SPECT/CT; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000002333
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract : Purpose: We aimed to (a) elucidate the concordance of visual assessment of an initial 123 I-ioflupane scan by a human interpreter with comparison to results using a fully automatic semiquantitative method and (b) to assess the accuracy compared to follow-up (f/u) diagnosis established by movement disorder specialists. Methods: An initial 123 I-ioflupane scan was performed in 382 patients with clinically uncertain Parkinsonian syndrome. An experienced reader performed a visual evaluation of all scans independently. The findings of the visual read were compared with semiquantitative evaluation. In addition, available f/u clinical diagnosis (serving as a reference standard) was compared with results of the human read and the software. Results: When comparing the semiquantitative method with the visual assessment, discordance could be found in 25 (6.5%) of 382 of the cases for the experienced reader (ĸ = 0.868). The human observer indicated region of interest misalignment as the main reason for discordance. With neurology f/u serving as reference, the results of the reader revealed a slightly higher accuracy rate (87.7%, ĸ = 0.75) compared to semiquantification (86.2%, ĸ = 0.719, P < 0.001, respectively). No significant difference in the diagnostic performance of the visual read versus software-based assessment was found. Conclusions: In comparison with a fully automatic semiquantitative method in 123 I-ioflupane interpretation, human assessment obtained an almost perfect agreement rate. However, compared to clinical established diagnosis serving as a reference, visual read seemed to be slightly more accurate as a solely software-based quantitative assessment.