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Diagnostic accuracy of T1-201 SPECT and MRI in brain diseases and inter-reader variance of diagnostic performance

T1-201 SPECT 和 MRI 对脑部疾病的诊断准确性以及诊断性能的读者间差异

基本信息

批准号：
06670933
负责人：
MACHIDA Kikuo
金额：
$ 1.34万
依托单位：
Saitama Medical School
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1994
资助国家：
日本
起止时间：
1994 至 1995
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-06670933/
关键词：
Brain Tumor T1-201 SPECT MRI CT Diagnostic accuracy Inter-observer variation ROC analysis 精神病・神経疾患老年性痴呆

项目摘要

Fifty-four studies of T1-201 brain tumor SPECT were independently interpreted by 9 nuclear medicine physicians with and without reference magnetic resonance images in 2 separate sessions to define an effect of referring images, and inter-observer variations. The physicians were requested to detect foci of abnormal deposits, and to discriminate whether they were malignant or not according to 5-grade scaling of subjective diagnostic confidence. Receiver-operating characteristics (ROC) analysis was performed. Mean sensitivity for presence of lesions (SFP), and sensitivity and specificity for malignancy of T1-201 SPECT were 84, and 53 and 55%, which were changed to 94, and 74 and 55% after referring to the MR images. The SFP was significantly improved (p<0.05), but sensitivity and specificity for malignancy, assessed by areas under the ROC curves, were not significantly improved. Inter-observer variation of the SFP was significantly reduced with addition of the referring MR images. Cerebral lobar localization of lesions by SPECT showed great inter-observer variations (true localization ranged from 30 to 68.4%). It is concluded that T1-201 brain tumor SPECT has moderate sensitivity and specifictity for malignancy, which is not improved by addition of anatomical refernce images, that additional MR images reduce inter-observer variation of confidence on lesion presence, and that SPECT localization of lesions has great inter-observer variations.

由9名核医学医生在2个单独的会议中独立解释了54项T1-201脑肿瘤SPECT研究（有和无参考磁共振图像），以定义参考图像的影响和观察者间的差异。要求医生检测异常沉积物的病灶，并根据主观诊断信心的5级评分来区分它们是否是恶性的。进行受试者工作特征（ROC）分析。T1-201 SPECT对病变存在（SFP）的平均敏感性、对恶性肿瘤的敏感性和特异性分别为84%、53%和55%，参考MR图像后分别为94%、74%和55%。SFP显著改善（p<0.05），但通过ROC曲线下面积评估的恶性肿瘤的敏感性和特异性没有显著改善。SFP的观察者之间的差异显着减少了参考MR图像的添加。SPECT脑叶病变定位显示观察者间差异很大（真实定位范围为30 - 68.4%）。它的结论是，T1-201脑肿瘤SPECT具有中等的灵敏度和特异性的恶性肿瘤，这是没有改善，通过增加解剖学的MRI图像，额外的MR图像减少观察者之间的变化的置信度病变的存在，SPECT定位病变有很大的观察者之间的变化。