Hiroshi Ohira1,2, Brian Mc Ardle1, Robert A deKemp1, Pablo Nery1, Daniel Juneau1,3, Jennifer M Renaud1, Ran Klein1, Owen Clarkin1, Karen MacDonald1, Eugene Leung4, Girish Nair1, Rob Beanlands1, David Birnie5. 1. Molecular Function and Imaging Program, the National Cardiac PET Centre and the Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Canada. 2. First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan. 3. Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada; and. 4. Division of Nuclear Medicine, Department of Medicine, the Ottawa Hospital, Ottawa, Ontario, Canada. 5. Molecular Function and Imaging Program, the National Cardiac PET Centre and the Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Canada dbirnie@ottawaheart.ca.
Abstract
Recent studies have reported the usefulness of 18F-FDG PET in aiding with the diagnosis and management of patients with cardiac sarcoidosis (CS). However, image interpretation of 18F-FDG PET for CS is sometimes challenging. We sought to investigate the inter- and intraobserver agreement and explore factors that led to important discrepancies between readers. Methods: We studied consecutive patients with no significant coronary artery disease who were referred for assessment of CS. Two experienced readers masked to clinical information, imaging reports, independently reviewed 18F-FDG PET/CT images. 18F-FDG PET/CT images were interpreted according to a predefined standard operating procedure, with cardiac 18F-FDG uptake patterns categorized into 5 patterns: none, focal, focal on diffuse, diffuse, and isolated lateral wall or basal uptake. Overall image assessment was classified as either consistent with active CS or not. Results: One hundred scans were included from 71 patients. Of these, 46 underwent 18F-FDG PET/CT with a no-restriction diet (no-restriction group), and 54 underwent 18F-FDG PET/CT with a low-carbohydrate, high-fat and protein-permitted diet (low-carb group). There was agreement of the interpretation category in 74 of 100 scans. The κ-value of agreement among all 5 categories was 0.64, indicating moderate agreement. For overall clinical interpretation, there was agreement in 93 of 100 scans (κ = 0.85). When scans were divided into the preparation groups, there was a trend toward higher agreement in the low-carb group versus the no-restriction group (80% vs. 67%, P = 0.08). Regarding the overall clinical interpretation, there was also a trend toward greater agreement in the low-carb group versus the no-restriction group (96% vs. 89%, P = 0.08). Conclusion: The interobserver agreement of cardiac 18F-FDG uptake image patterns was moderate. However, agreement was better regarding overall interpretation of CS. Detailed prescan dietary preparation seemed to improve interobserver agreement.
Recent studies have reported the usefulness of 18F-FDG PET in aiding with the diagnosis and management of patients with cardiac sarcoidosis (CS). However, image interpretation of 18F-FDG PET for CS is sometimes challenging. We sought to investigate the inter- and intraobserver agreement and explore factors that led to important discrepancies between readers. Methods: We studied consecutive patients with no significant coronary artery disease who were referred for assessment of CS. Two experienced readers masked to clinical information, imaging reports, independently reviewed 18F-FDG PET/CT images. 18F-FDG PET/CT images were interpreted according to a predefined standard operating procedure, with cardiac 18F-FDG uptake patterns categorized into 5 patterns: none, focal, focal on diffuse, diffuse, and isolated lateral wall or basal uptake. Overall image assessment was classified as either consistent with active CS or not. Results: One hundred scans were included from 71 patients. Of these, 46 underwent 18F-FDG PET/CT with a no-restriction diet (no-restriction group), and 54 underwent 18F-FDG PET/CT with a low-carbohydrate, high-fat and protein-permitted diet (low-carb group). There was agreement of the interpretation category in 74 of 100 scans. The κ-value of agreement among all 5 categories was 0.64, indicating moderate agreement. For overall clinical interpretation, there was agreement in 93 of 100 scans (κ = 0.85). When scans were divided into the preparation groups, there was a trend toward higher agreement in the low-carb group versus the no-restriction group (80% vs. 67%, P = 0.08). Regarding the overall clinical interpretation, there was also a trend toward greater agreement in the low-carb group versus the no-restriction group (96% vs. 89%, P = 0.08). Conclusion: The interobserver agreement of cardiac 18F-FDG uptake image patterns was moderate. However, agreement was better regarding overall interpretation of CS. Detailed prescan dietary preparation seemed to improve interobserver agreement.
Authors: Afnan A Malaih; Joel T Dunn; Lotte Nygård; David G Kovacs; Flemming L Andersen; Sally F Barrington; Barbara M Fischer Journal: Nucl Med Commun Date: 2022-05-01 Impact factor: 1.698
Authors: Patrick Martineau; Matthieu Pelletier-Galarneau; Daniel Juneau; Eugene Leung; Pablo Nery; Rob deKemp; Rob Beanlands; David Birnie Journal: EJNMMI Res Date: 2020-12-10 Impact factor: 3.138
Authors: Cheuk To Chung; George Bazoukis; Sharen Lee; Ying Liu; Tong Liu; Konstantinos P Letsas; Antonis A Armoundas; Gary Tse Journal: Int J Arrhythmia Date: 2022-04-01