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Two-position supine/prone myocardial perfusion SPECT (MPS) imaging improves visual inter-observer correlation and agreement

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Objectives

We aimed to compare the inter-observer agreement between two experienced readers using supine vs combined supine/prone myocardial perfusion SPECT (MPS) in a large population.

Methods

1,181 consecutive patients without known coronary artery disease (CAD) undergoing rest 201Tl/stress 99mTc-sestamibi MPS studies were evaluated. Visual reads were performed in two consecutive steps, with readers scoring the stress supine perfusion images during step 1 and rescoring the images using both supine/prone data during step 2. Visual summed stress scores (SSS) of two readers including regional scores in different vascular territories were compared.

Results

The specificity for both readers improved using combined supine/prone imaging (reader 1: 92% vs 86% [P = .0002], reader 2: 88% vs 72% [P < .0001]). The inter-observer correlation for SSS (0.90 vs 0.84, P < .0001) and inter-observer agreement for combined supine/prone reading (bias = 1.0, 95% confidence interval (CI) 0.9-1.2 vs bias = 3.1, 95% CI 2.8-3.4, P < .0001) were significantly better as compared to supine-only reading. The overall correlation between SSS scores for two readers improved with supine/prone imaging for both genders, as well as in the left anterior descending and right coronary territories.

Conclusion

The inter-observer correlation and agreement significantly improve using two-position supine/prone vs supine-only imaging.

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Acknowledgments

This research was supported in part by Grants R01HL089765 from the National Heart, Lung, and Blood Institute/National Institutes of Health (NHLBI/NIH). We would like to thank Dr. Caroline Kilian and Arpine Oganyan for proof reading the text, Mr. Jim Gerlach for quality controls of the data, and Ms. Heidi Gransar for the statistical analysis.

Disclosures

This research are solely the responsibility of the authors and do not necessarily represent the official views of the NHLBI. Cedars-Sinai Medical Center receives royalties for the quantitative assessment of function, perfusion, and viability, a portion of which is distributed to some of the authors of this manuscript (DB, GG, PS).

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Authors and Affiliations

  1. Departments of Imaging and Medicine, and Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA

    Reza Arsanjani MD, Sean W. Hayes MD, Aryeh Shalev MD, Rine Nakanishi MD, Louise EJ Thomson MD, John D. Friedman MD, Guido Germano PhD, Daniel S. Berman MD & Piotr Slomka PhD

  2. Oregon Heart and Vascular Institute, Sacred Heart Medical Center, Springfield, OR, USA

    Mathews Fish MD

  3. David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Guido Germano PhD & Piotr Slomka PhD

Authors
  1. Reza Arsanjani MD
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  2. Sean W. Hayes MD
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  3. Mathews Fish MD
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  4. Aryeh Shalev MD
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  5. Rine Nakanishi MD
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  6. Louise EJ Thomson MD
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  7. John D. Friedman MD
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  8. Guido Germano PhD
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  9. Daniel S. Berman MD
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  10. Piotr Slomka PhD
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Corresponding author

Correspondence to Piotr Slomka PhD.

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Arsanjani, R., Hayes, S.W., Fish, M. et al. Two-position supine/prone myocardial perfusion SPECT (MPS) imaging improves visual inter-observer correlation and agreement. J. Nucl. Cardiol. 21, 703–711 (2014). https://doi.org/10.1007/s12350-014-9895-3

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  • DOI: https://doi.org/10.1007/s12350-014-9895-3

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