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Improved beta-amyloid PET reproducibility using two-phase acquisition and grey matter delineation

PURPOSE: We investigated whether the reproducibility of standard visual reporting (STD method) in flutemetamol (FMM) PET can be improved using a newly introduced method that uses grey matter edges derived from the perfusion phase (GM-EDGE method). METHODS: Two-phase FMM PET was performed in 121 pati...

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Autores principales: Belohlavek, Otakar, Jaruskova, Monika, Skopalova, Magdalena, Szarazova, Gabriela, Simonova, Katerina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333723/
https://www.ncbi.nlm.nih.gov/pubmed/30159586
http://dx.doi.org/10.1007/s00259-018-4140-y
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author Belohlavek, Otakar
Jaruskova, Monika
Skopalova, Magdalena
Szarazova, Gabriela
Simonova, Katerina
author_facet Belohlavek, Otakar
Jaruskova, Monika
Skopalova, Magdalena
Szarazova, Gabriela
Simonova, Katerina
author_sort Belohlavek, Otakar
collection PubMed
description PURPOSE: We investigated whether the reproducibility of standard visual reporting (STD method) in flutemetamol (FMM) PET can be improved using a newly introduced method that uses grey matter edges derived from the perfusion phase (GM-EDGE method). METHODS: Two-phase FMM PET was performed in 121 patients with mild cognitive impairment. Five nuclear medicine physicians blindly and independently evaluated all late-phase scans, initially employing the STD method and later the GM-EDGE method. A five-point scale was used to express the degree of amyloid positivity, and a binary classification (positive/negative) was used in combination with subjective confidence (five-point scale). Multirater Fleiss’ kappa, intraclass correlation coefficient (ICC) and inter-rater reliability (Cohen’s kappa) were determined for the STD and GM-EDGE methods. RESULTS: The weighted Cohen’s kappa values for the five-point measure of amyloid positivity ranged from 0.63 to 0.73 (median 0.70) for the STD method and from 0.76 to 0.89 (median 0.80) for the GM-EDGE method (ICC 0.84, 95% CI 0.79–0.88, for the STD method; 0.91, 95% CI 0.89–0.94, for the GM-EDGE method). The nonweighted Cohen’s kappa value for the binary classification ranged from 0.73 to 0.93 (median 0.82) for the STD method and 0.90 to 0.97 (median 0.93) for the GM-EDGE method (Fleiss’ kappa 0.82, 95% CI 0.77–0.88, for the STD method; 0.93, 95% CI 0.87–0.99, for the GM-EDGE method). The GM-EDGE method resulted in significantly greater subjective confidence in the readings of four physicians (p < 0.010). The binary classification was concordant among all five physicians in 80.8% of the scans using the STD method and in 91.6% of the scans using the GM-EDGE method (p = 0.016). CONCLUSION: The newly introduced GM-EDGE method was associated with significantly higher inter-rater agreement among physicians and higher subjective confidence in the reading. The method is easy to implement in clinical practice, especially when the perfusion phase is utilized clinically.
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spelling pubmed-63337232019-01-27 Improved beta-amyloid PET reproducibility using two-phase acquisition and grey matter delineation Belohlavek, Otakar Jaruskova, Monika Skopalova, Magdalena Szarazova, Gabriela Simonova, Katerina Eur J Nucl Med Mol Imaging Original Article PURPOSE: We investigated whether the reproducibility of standard visual reporting (STD method) in flutemetamol (FMM) PET can be improved using a newly introduced method that uses grey matter edges derived from the perfusion phase (GM-EDGE method). METHODS: Two-phase FMM PET was performed in 121 patients with mild cognitive impairment. Five nuclear medicine physicians blindly and independently evaluated all late-phase scans, initially employing the STD method and later the GM-EDGE method. A five-point scale was used to express the degree of amyloid positivity, and a binary classification (positive/negative) was used in combination with subjective confidence (five-point scale). Multirater Fleiss’ kappa, intraclass correlation coefficient (ICC) and inter-rater reliability (Cohen’s kappa) were determined for the STD and GM-EDGE methods. RESULTS: The weighted Cohen’s kappa values for the five-point measure of amyloid positivity ranged from 0.63 to 0.73 (median 0.70) for the STD method and from 0.76 to 0.89 (median 0.80) for the GM-EDGE method (ICC 0.84, 95% CI 0.79–0.88, for the STD method; 0.91, 95% CI 0.89–0.94, for the GM-EDGE method). The nonweighted Cohen’s kappa value for the binary classification ranged from 0.73 to 0.93 (median 0.82) for the STD method and 0.90 to 0.97 (median 0.93) for the GM-EDGE method (Fleiss’ kappa 0.82, 95% CI 0.77–0.88, for the STD method; 0.93, 95% CI 0.87–0.99, for the GM-EDGE method). The GM-EDGE method resulted in significantly greater subjective confidence in the readings of four physicians (p < 0.010). The binary classification was concordant among all five physicians in 80.8% of the scans using the STD method and in 91.6% of the scans using the GM-EDGE method (p = 0.016). CONCLUSION: The newly introduced GM-EDGE method was associated with significantly higher inter-rater agreement among physicians and higher subjective confidence in the reading. The method is easy to implement in clinical practice, especially when the perfusion phase is utilized clinically. Springer Berlin Heidelberg 2018-08-29 2019 /pmc/articles/PMC6333723/ /pubmed/30159586 http://dx.doi.org/10.1007/s00259-018-4140-y Text en © The Author(s) 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Belohlavek, Otakar
Jaruskova, Monika
Skopalova, Magdalena
Szarazova, Gabriela
Simonova, Katerina
Improved beta-amyloid PET reproducibility using two-phase acquisition and grey matter delineation
title Improved beta-amyloid PET reproducibility using two-phase acquisition and grey matter delineation
title_full Improved beta-amyloid PET reproducibility using two-phase acquisition and grey matter delineation
title_fullStr Improved beta-amyloid PET reproducibility using two-phase acquisition and grey matter delineation
title_full_unstemmed Improved beta-amyloid PET reproducibility using two-phase acquisition and grey matter delineation
title_short Improved beta-amyloid PET reproducibility using two-phase acquisition and grey matter delineation
title_sort improved beta-amyloid pet reproducibility using two-phase acquisition and grey matter delineation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333723/
https://www.ncbi.nlm.nih.gov/pubmed/30159586
http://dx.doi.org/10.1007/s00259-018-4140-y
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