TY - JOUR
T1 - Observer variability in the evaluation of dual-isotope Tl-201/Tc-99m sestamibi rest/stress myocardial perfusion SPECT in men and women with known or suspected stable angina pectoris
AU - Johansen, Allan
AU - Høilund-Carlsen, Poul Flemming
AU - Christensen, Henrik Wulff
AU - Grupe, Peter
AU - Veje, Annegrete
AU - Vach, Werner
AU - Haghfelt, Torben
PY - 2004
Y1 - 2004
N2 - BACKGROUND: Observer variability of dual-isotope myocardial perfusion imaging (MPI) with single photon emission computed tomography has rarely been investigated. The aim of our study was to evaluate the interpretive reproducibility with this technique. METHODS AND RESULTS: We report on 507 patients with known or suspected stable angina who were studied before coronary angiography. A 1-day thallium 201/technetium 99m sestamibi rest/stress MPI protocol was used. MPI was interpreted by 2 independent observers without knowledge of clinical data, using a 20-segment scoring model. By consensus, the overall rate of abnormal MPI was 49% (59% in men and 34% in women). The interobserver agreement for the whole group (kappa = 0.85) and for men and women separately (kappa = 0.86 and 0.82, respectively) was excellent with regard to the overall diagnosis (normal, reversible, or fixed defects) as well as left anterior descending and left circumflex artery vascular territories (kappa = 0.85 and 0.82, respectively). However, in the right coronary artery territory, agreement was excellent in men (kappa = 0.83) but moderate in women (kappa = 0.57). CONCLUSIONS: In a relatively large group of men and women with stable angina pectoris, interpretive reproducibility (overall and individual vessel diagnosis) was excellent, except in the right coronary artery territory of women, in which it was moderate.
AB - BACKGROUND: Observer variability of dual-isotope myocardial perfusion imaging (MPI) with single photon emission computed tomography has rarely been investigated. The aim of our study was to evaluate the interpretive reproducibility with this technique. METHODS AND RESULTS: We report on 507 patients with known or suspected stable angina who were studied before coronary angiography. A 1-day thallium 201/technetium 99m sestamibi rest/stress MPI protocol was used. MPI was interpreted by 2 independent observers without knowledge of clinical data, using a 20-segment scoring model. By consensus, the overall rate of abnormal MPI was 49% (59% in men and 34% in women). The interobserver agreement for the whole group (kappa = 0.85) and for men and women separately (kappa = 0.86 and 0.82, respectively) was excellent with regard to the overall diagnosis (normal, reversible, or fixed defects) as well as left anterior descending and left circumflex artery vascular territories (kappa = 0.85 and 0.82, respectively). However, in the right coronary artery territory, agreement was excellent in men (kappa = 0.83) but moderate in women (kappa = 0.57). CONCLUSIONS: In a relatively large group of men and women with stable angina pectoris, interpretive reproducibility (overall and individual vessel diagnosis) was excellent, except in the right coronary artery territory of women, in which it was moderate.
KW - Angina Pectoris
KW - Denmark
KW - Exercise Test
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Observer Variation
KW - Radiopharmaceuticals
KW - Reproducibility of Results
KW - Rest
KW - Sensitivity and Specificity
KW - Sex Distribution
KW - Single-Blind Method
KW - Subtraction Technique
KW - Technetium Tc 99m Sestamibi
KW - Thallium
KW - Tomography, Emission-Computed, Single-Photon
U2 - 10.1016/j.nuclcard.2004.06.130
DO - 10.1016/j.nuclcard.2004.06.130
M3 - Journal article
C2 - 15592195
SN - 1071-3581
VL - 11
SP - 710
EP - 718
JO - Journal of Nuclear Cardiology
JF - Journal of Nuclear Cardiology
IS - 6
ER -