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The influence of digital PET/CT on diagnostic certainty and interrater reliability in [(68)Ga]Ga-PSMA-11 PET/CT for recurrent prostate cancer
OBJECTIVE: To investigate the impact of digital PET/CT on diagnostic certainty, patient-based sensitivity and interrater reliability. METHODS: Four physicians retrospectively evaluated two matched cohorts of patients undergoing [(68)Ga]Ga-PSMA-11 PET/CT on a digital (dPET/CT n = 65) or an analogue s...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8452558/ https://www.ncbi.nlm.nih.gov/pubmed/33856522 http://dx.doi.org/10.1007/s00330-021-07870-5 |
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author | Alberts, Ian Hünermund, Jan-Niklas Sachpekidis, Christos Mingels, Clemens Fech, Viktor Bohn, Karl Peter Rominger, Axel Afshar-Oromieh, Ali |
author_facet | Alberts, Ian Hünermund, Jan-Niklas Sachpekidis, Christos Mingels, Clemens Fech, Viktor Bohn, Karl Peter Rominger, Axel Afshar-Oromieh, Ali |
author_sort | Alberts, Ian |
collection | PubMed |
description | OBJECTIVE: To investigate the impact of digital PET/CT on diagnostic certainty, patient-based sensitivity and interrater reliability. METHODS: Four physicians retrospectively evaluated two matched cohorts of patients undergoing [(68)Ga]Ga-PSMA-11 PET/CT on a digital (dPET/CT n = 65) or an analogue scanner (aPET/CT n = 65) for recurrent prostate cancer between 11/2018 and 03/2019. The number of equivocal and pathological lesions as well as the frequency of discrepant findings and the interrater reliability for the two scanners were compared. RESULTS: dPET/CT detected more lesions than aPET/CT (p < 0.001). A higher number of pathological scans were observed for dPET/CT (83% vs. 57%, p < 0.001). The true-positive rate at follow-up was 100% for dPET/CT compared to 84% for aPET/CT (p < 0.001). The proportion of lesions rated as non-pathological as a total of all PSMA-avid lesions detected for dPET/CT was comparable to aPET/CT (61.8% vs. 57.0%, p = 0.99). Neither a higher rate of diagnostically uncertain lesions (11.5% dPET/CT vs. 13.7% aPET/CT, p = 0.95) nor discrepant scans (where one or more readers differed in opinion as to whether the scan is pathological) were observed (18% dPET/CT vs. 17% aPET/CT, p = 0.76). Interrater reliability for pathological lesions was excellent for both scanner types (Cronbach’s α = 0.923 dPET/CT; α = 0.948 aPET/CT) and interrater agreement was substantial for dPET/CT (Krippendorf’s α = 0.701) and almost perfect in aPET/CT (α = 0.802). CONCLUSIONS: A higher detection rate for pathological lesions for dPET/CT compared with aPET/CT in multiple readers was observed. This improved sensitivity was coupled with an improved true-positive rate and was not associated with increased diagnostic uncertainty, rate of non-specific lesions, or reduced interrater reliability. KEY POINTS: • New generation digital scanners detect more cancer lesions in men with prostate cancer. • When using digital scanners, the doctors are able to diagnose prostate cancer lesions with better certainty • When using digital scanners, the doctors do not disagree with each other more than with other scanner types. |
format | Online Article Text |
id | pubmed-8452558 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-84525582021-10-05 The influence of digital PET/CT on diagnostic certainty and interrater reliability in [(68)Ga]Ga-PSMA-11 PET/CT for recurrent prostate cancer Alberts, Ian Hünermund, Jan-Niklas Sachpekidis, Christos Mingels, Clemens Fech, Viktor Bohn, Karl Peter Rominger, Axel Afshar-Oromieh, Ali Eur Radiol Nuclear Medicine OBJECTIVE: To investigate the impact of digital PET/CT on diagnostic certainty, patient-based sensitivity and interrater reliability. METHODS: Four physicians retrospectively evaluated two matched cohorts of patients undergoing [(68)Ga]Ga-PSMA-11 PET/CT on a digital (dPET/CT n = 65) or an analogue scanner (aPET/CT n = 65) for recurrent prostate cancer between 11/2018 and 03/2019. The number of equivocal and pathological lesions as well as the frequency of discrepant findings and the interrater reliability for the two scanners were compared. RESULTS: dPET/CT detected more lesions than aPET/CT (p < 0.001). A higher number of pathological scans were observed for dPET/CT (83% vs. 57%, p < 0.001). The true-positive rate at follow-up was 100% for dPET/CT compared to 84% for aPET/CT (p < 0.001). The proportion of lesions rated as non-pathological as a total of all PSMA-avid lesions detected for dPET/CT was comparable to aPET/CT (61.8% vs. 57.0%, p = 0.99). Neither a higher rate of diagnostically uncertain lesions (11.5% dPET/CT vs. 13.7% aPET/CT, p = 0.95) nor discrepant scans (where one or more readers differed in opinion as to whether the scan is pathological) were observed (18% dPET/CT vs. 17% aPET/CT, p = 0.76). Interrater reliability for pathological lesions was excellent for both scanner types (Cronbach’s α = 0.923 dPET/CT; α = 0.948 aPET/CT) and interrater agreement was substantial for dPET/CT (Krippendorf’s α = 0.701) and almost perfect in aPET/CT (α = 0.802). CONCLUSIONS: A higher detection rate for pathological lesions for dPET/CT compared with aPET/CT in multiple readers was observed. This improved sensitivity was coupled with an improved true-positive rate and was not associated with increased diagnostic uncertainty, rate of non-specific lesions, or reduced interrater reliability. KEY POINTS: • New generation digital scanners detect more cancer lesions in men with prostate cancer. • When using digital scanners, the doctors are able to diagnose prostate cancer lesions with better certainty • When using digital scanners, the doctors do not disagree with each other more than with other scanner types. Springer Berlin Heidelberg 2021-04-15 2021 /pmc/articles/PMC8452558/ /pubmed/33856522 http://dx.doi.org/10.1007/s00330-021-07870-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Nuclear Medicine Alberts, Ian Hünermund, Jan-Niklas Sachpekidis, Christos Mingels, Clemens Fech, Viktor Bohn, Karl Peter Rominger, Axel Afshar-Oromieh, Ali The influence of digital PET/CT on diagnostic certainty and interrater reliability in [(68)Ga]Ga-PSMA-11 PET/CT for recurrent prostate cancer |
title | The influence of digital PET/CT on diagnostic certainty and interrater reliability in [(68)Ga]Ga-PSMA-11 PET/CT for recurrent prostate cancer |
title_full | The influence of digital PET/CT on diagnostic certainty and interrater reliability in [(68)Ga]Ga-PSMA-11 PET/CT for recurrent prostate cancer |
title_fullStr | The influence of digital PET/CT on diagnostic certainty and interrater reliability in [(68)Ga]Ga-PSMA-11 PET/CT for recurrent prostate cancer |
title_full_unstemmed | The influence of digital PET/CT on diagnostic certainty and interrater reliability in [(68)Ga]Ga-PSMA-11 PET/CT for recurrent prostate cancer |
title_short | The influence of digital PET/CT on diagnostic certainty and interrater reliability in [(68)Ga]Ga-PSMA-11 PET/CT for recurrent prostate cancer |
title_sort | influence of digital pet/ct on diagnostic certainty and interrater reliability in [(68)ga]ga-psma-11 pet/ct for recurrent prostate cancer |
topic | Nuclear Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8452558/ https://www.ncbi.nlm.nih.gov/pubmed/33856522 http://dx.doi.org/10.1007/s00330-021-07870-5 |
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