IBZM SPECT and FDG PET in the differential diagnosis of Parkinsonian syndromes: comparison with respect to inter-rater agreement.
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IBZM SPECT and FDG PET in the differential diagnosis of Parkinsonian syndromes: comparison with respect to inter-rater agreement. / Derlin, Thorsten; Afzal, Wana; Wilke, Florian; Apostolova, I; Klutmann, Susanne; Meyer, P T; Buhmann, Carsten; Hesse, S; Buchert, Ralph.
in: NUKLEARMED-NUCL MED, Jahrgang 49, Nr. 4, 4, 2010, S. 139-147.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - IBZM SPECT and FDG PET in the differential diagnosis of Parkinsonian syndromes: comparison with respect to inter-rater agreement.
AU - Derlin, Thorsten
AU - Afzal, Wana
AU - Wilke, Florian
AU - Apostolova, I
AU - Klutmann, Susanne
AU - Meyer, P T
AU - Buhmann, Carsten
AU - Hesse, S
AU - Buchert, Ralph
PY - 2010
Y1 - 2010
N2 - AIM: Both IBZM SPECT and FDG PET may be used for differentiation between Parkinson's disease (PD) and atypical neurodegenerative parkinsonian syndromes (APS). However, there are only very limited data of both modalities in the same subjects. The present study compared both modalities with respect to inter-rater agreement in 30 patients with neurodegenerative parkinsonian syndromes (PS) confirmed by FP-CIT SPECT.METHODS: IBZM SPECT and FDG PET were categorized as PD or APS by visual inspection of standardized report pages and statistical parametric maps (SPMs). Categorization was performed independently by five readers. Inter-rater agreement was quantified using Cohen's kappa kappa.RESULTS: IBZM SPECT resulted in PD and APS in 11 and 19 cases, respectively (majoritarian categorization). Inter-rater agreement was kappa=0.64+/-0.10. FDG PET resulted in PD and APS in 12 and 18 cases, respectively (majoritarian categorization). Inter-rater agreement was kappa=0.68+/-0.07. Majoritarian diagnosis disagreed between IBZM SPECT and FDG PET in 13 cases (43%). Semi-quantitative analysis of IBZM SPECT using the striatum-to-reference distribution volume ratio was in good agreement with visual categorization (area under ROC curve 0.92).CONCLUSION: In neurodegenerative PS, inter-rater agreement of visual analysis is substantial in both IBZM SPECT and FDG PET. Furthermore, (I) visual analysis of IBZM SPECT is reliable if adequate standardized image display is used, (II) visual analysis of FDG SPMs allows unique categorization as either PD or APS in most subjects, and (III) IBZM SPECT and FDG PET are discordant in a significant fraction of cases.
AB - AIM: Both IBZM SPECT and FDG PET may be used for differentiation between Parkinson's disease (PD) and atypical neurodegenerative parkinsonian syndromes (APS). However, there are only very limited data of both modalities in the same subjects. The present study compared both modalities with respect to inter-rater agreement in 30 patients with neurodegenerative parkinsonian syndromes (PS) confirmed by FP-CIT SPECT.METHODS: IBZM SPECT and FDG PET were categorized as PD or APS by visual inspection of standardized report pages and statistical parametric maps (SPMs). Categorization was performed independently by five readers. Inter-rater agreement was quantified using Cohen's kappa kappa.RESULTS: IBZM SPECT resulted in PD and APS in 11 and 19 cases, respectively (majoritarian categorization). Inter-rater agreement was kappa=0.64+/-0.10. FDG PET resulted in PD and APS in 12 and 18 cases, respectively (majoritarian categorization). Inter-rater agreement was kappa=0.68+/-0.07. Majoritarian diagnosis disagreed between IBZM SPECT and FDG PET in 13 cases (43%). Semi-quantitative analysis of IBZM SPECT using the striatum-to-reference distribution volume ratio was in good agreement with visual categorization (area under ROC curve 0.92).CONCLUSION: In neurodegenerative PS, inter-rater agreement of visual analysis is substantial in both IBZM SPECT and FDG PET. Furthermore, (I) visual analysis of IBZM SPECT is reliable if adequate standardized image display is used, (II) visual analysis of FDG SPMs allows unique categorization as either PD or APS in most subjects, and (III) IBZM SPECT and FDG PET are discordant in a significant fraction of cases.
KW - Diagnosis, Differential
KW - Humans
KW - Reproducibility of Results
KW - Patient Selection
KW - Observer Variation
KW - Benzamides diagnostic use
KW - Dopamine Antagonists diagnostic use
KW - Fluorodeoxyglucose F18 diagnostic use
KW - Parkinsonian Disorders radionuclide imaging
KW - Positron-Emission Tomography methods
KW - Pyrrolidines diagnostic use
KW - Tomography, Emission-Computed, Single-Photon methods
KW - Diagnosis, Differential
KW - Humans
KW - Reproducibility of Results
KW - Patient Selection
KW - Observer Variation
KW - Benzamides diagnostic use
KW - Dopamine Antagonists diagnostic use
KW - Fluorodeoxyglucose F18 diagnostic use
KW - Parkinsonian Disorders radionuclide imaging
KW - Positron-Emission Tomography methods
KW - Pyrrolidines diagnostic use
KW - Tomography, Emission-Computed, Single-Photon methods
U2 - 10.3413/nukmed-0290
DO - 10.3413/nukmed-0290
M3 - SCORING: Journal article
C2 - 20502846
VL - 49
SP - 139
EP - 147
JO - NUKLEARMED-NUCL MED
JF - NUKLEARMED-NUCL MED
SN - 0029-5566
IS - 4
M1 - 4
ER -
