A Novel Timesaving Method for Hepatobiliary Imaging for Suspected Acute Cholecystitis
A Novel Timesaving Method for Hepatobiliary Imaging for Suspected Acute Cholecystitis
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DOI：
10.1067/j.cpradiol.2016.04.005
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发表时间：
2017-01-01
影响因子：
1.4
通讯作者：
Halkar, Raghuveer K.
中科院分区：
文献类型：
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作者：
Carter, Shawn S.;Ehsan, Syed Ramisa;Halkar, Raghuveer K.
目的：在不损失诊断准确率的前提下，优化疑似急性胆囊炎的核素胆道造影的资源利用率。材料和方法：本研究获得机构评审委员会的批准。回顾81例疑似急性胆囊炎患者的肝胆成像数据，仅使用动态图像的前5分钟和最后5分钟，将其修改为2幅总和静态图像，从而消除了中间50分钟的成像数据。两名核医学医生解释了汇总的图像以评估可视化，并将这些解释与基于全部60分钟动态成像的原始报告进行了比较。第三位核医学医生调解了罕见的读者之间的解释分歧。使用Cohen lc系数分析对省时方法和常规方法的解释以及观察者间的变异性进行比较。结果：使用省时方法的解释与基于全动态成像方案的解释几乎完全一致(两个读取器的Cohen kappa系数均为0.92)。结论：在疑似急性胆囊炎的情况下，通过减少伽马相机和技术人员的时间，可以在不牺牲诊断准确性的情况下，使用一种新的节省时间的方法来提高影像资源的利用率。然而，多中心更大规模的试验将是建立重复性所必需的。(C)2016 Elsevier Inc.保留所有权利。
Objective: To optimize resource utilization of cholescintigraphy for suspected acute cholecystitis with a time-saving method without a loss in diagnostic accuracy.Materials and Methods: Institutional review board approval was obtained for this retrospective study. Hepatobiliary imaging data for 81 patients with suspected acute cholecystitis were recalled for modification into 2 summed static images, using only the first and last 5 minutes of the dynamic images, thereby eliminating the middle 50 minutes of imaging data. Two nuclear medicine physicians interpreted the summed images to assess visualization, and those interpretations were compared to the original reports based on using all 60 minutes of dynamic imaging. A third nuclear medicine physician mediated rare inter-reader interpretive disagreements. Comparison of interpretations of time-saving and conventional methods and also inter-observer variability was achieved using the Cohen lc coefficient analysis.Results: Interpretations rendered using the time-saving method showed near-perfect agreement with those based on the full dynamic imaging protocol (Cohen kappa coefficient = 0.92 for both readers). Furthermore, nuclear medicine physician readers agreed with each other (Cohen lc coefficient = 0.95 between the 2 readers), indicating minimal inter-observer variability using this novel optimized technique.Conclusion: In the setting of suspected acute cholecystitis, imaging resource utilization may be improved, via reduced gamma camera and technologist time, using a novel time-saving method without sacrificing diagnostic accuracy. Multicenter larger trials, however, will be necessary to establish reproducibility. (C) 2016 Elsevier Inc. All rights reserved.