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01.07.2010 | Original Article

SPECT/CT stabilizes the interpretation of somatostatin receptor scintigraphy findings: a retrospective analysis of inter-rater agreement

verfasst von: Ivayla Apostolova, Swantje Riethdorf, Ralph Buchert, Thorsten Derlin, Winfried Brenner, Janos Mester, Susanne Klutmann

Erschienen in: Annals of Nuclear Medicine | Ausgabe 6/2010

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Abstract

Objective

Correlating the anatomical information from CT with the functional information from SPECT improves diagnostic accuracy of somatostatin-receptor-scintigraphy (SRS) in patients with neuroendocrine tumors (NET). The aim of the present study was to investigate the impact of dual modality SPECT/CT on the inter-rater agreement in SRS.

Methods

Twenty-five unselected patients with suspected or histologically proven NET in whom whole body planar imaging and low-dose SPECT/CT had been performed after injection of 200 MBq In-111-octreotide were included retrospectively. Images were interpreted independently by 2 nuclear medicine physicians, an experienced one and an inexperienced one. Both readers first re-evaluated the planar whole-body images alone, then added the SPECT images, and finally the CT-images. Lesions with pathologically increased tracer uptake were categorized according to the following 3-point score: equivocal, probably pathologic, and definitely pathologic. Cohen’s linear-weighted kappa coefficient κ was used to quantify inter-rater agreement.

Results

A total number of 50 lesions were described in 23 of the 25 patients. The two readers showed only moderate agreement in the interpretation of the planar findings (κ = 0.593). Agreement improved to substantial by adding SPECT (κ = 0.736) and to very good by adding SPECT/CT (κ = 0.860). SPECT/CT resulted in up-staging of 18% of the lesions and down-staging of 12% compared to planar + SPECT (experienced reader). In addition, SPECT/CT tended to reduce the frequency of indefinite scores (equivocal, probably pathologic), from 18% in planar + SPECT to 6% (p = 0.065). Change of lesion localization by SPECT/CT tended to contribute to the change of lesion score (p = 0.055).

Conclusion

The present results suggest that low-dose SPECT/CT stabilizes report quality in SRS by improving inter-rater agreement.

Balon HR, Goldsmith SJ, Siegel BA, Silberstein EB, Krenning EP, Lang O, et al. Procedure guideline for somatostatin receptor scintigraphy with (111)In-pentetreotide. J Nucl Med. 2001;42:1134–8.PubMed

Gotthardt M, Dirkmorfeld LM, Wied MU, Rinke A, Behe MP, Schlieck A, et al. Influence of somatostatin receptor scintigraphy and CT/MRI on the clinical management of patients with gastrointestinal neuroendocrine tumors: an analysis in 188 patients. Digestion. 2003;68:80–5.CrossRefPubMed

Krausz Y, Israel O. Single-photon emission computed tomography/computed tomography in endocrinology. Semin Nucl Med. 2006;36:267–74.CrossRefPubMed

Schillaci O, Spanu A, Scopinaro F, Falchi A, Corleto V, Danieli R, et al. Somatostatin receptor scintigraphy with 111In-pentetreotide in non-functioning gastroenteropancreatic neuroendocrine tumors. Int J Oncol. 2003;23:1687–95.PubMed

Krausz Y, Bar-Ziv J, de Jong RB, Ish-Shalom S, Chisin R, Shibley N, et al. Somatostatin-receptor scintigraphy in the management of gastroenteropancreatic tumors. Am J Gastroenterol. 1998;93:66–70.CrossRefPubMed

Lebtahi R, Cadiot G, Sarda L, Daou D, Faraggi M, Petegnief Y, et al. Clinical impact of somatostatin receptor scintigraphy in the management of patients with neuroendocrine gastroenteropancreatic tumors. J Nucl Med. 1997;38:853–8.PubMed

Schillaci O. Somatostatin receptor imaging in patients with neuroendocrine tumors: not only SPECT? J Nucl Med. 2007;48:498–500.CrossRefPubMed

Schillaci O, Massa R, Scopinaro F. 111In-pentetreotide scintigraphy in the detection of insulinomas: importance of SPECT imaging. J Nucl Med. 2000;41:459–62.PubMed

Schillaci O, Scopinaro F, Angeletti S, Tavolaro R, Danieli R, Annibale B, et al. SPECT improves accuracy of somatostatin receptor scintigraphy in abdominal carcinoid tumors. J Nucl Med. 1996;37:1452–6.PubMed

10.

Castaldi P, Rufini V, Treglia G, Bruno I, Perotti G, Stifano G, et al. Impact of (111)In-DTPA-octreotide SPECT/CT fusion images in the management of neuroendocrine tumours. Radiol Med. 2008;113:1056–67.CrossRefPubMed

11.

Even-Sapir E, Keidar Z, Sachs J, Engel A, Bettman L, Gaitini D, et al. The new technology of combined transmission and emission tomography in evaluation of endocrine neoplasms. J Nucl Med. 2001;42:998–1004.PubMed

12.

Hillel PG, van Beek EJ, Taylor C, Lorenz E, Bax ND, Prakash V, et al. The clinical impact of a combined gamma camera/CT imaging system on somatostatin receptor imaging of neuroendocrine tumours. Clin Radiol. 2006;61:579–87.CrossRefPubMed

13.

Krausz Y, Keidar Z, Kogan I, Even-Sapir E, Bar-Shalom R, Engel A, et al. SPECT/CT hybrid imaging with 111In-pentetreotide in assessment of neuroendocrine tumours. Clin Endocrinol (Oxf). 2003;59:565–73.CrossRef

14.

Pfannenberg AC, Eschmann SM, Horger M, Lamberts R, Vonthein R, Claussen CD, et al. Benefit of anatomical-functional image fusion in the diagnostic work-up of neuroendocrine neoplasms. Eur J Nucl Med Mol Imaging. 2003;30:835–43.PubMed

15.

Perri M, Erba P, Volterrani D, Lazzeri E, Boni G, Grosso M, et al. Octreo-SPECT/CT imaging for accurate detection and localization of suspected neuroendocrine tumors. Q J Nucl Med Mol Imaging. 2008;52:323–33.PubMed

16.

Sadik M, Suurkula M, Hoglund P, Jarund A, Edenbrandt L. Quality of planar whole-body bone scan interpretations—a nationwide survey. Eur J Nucl Med Mol Imaging. 2008;35:1464–72.CrossRefPubMed

17.

Plathow C, Staab A, Schmaehl A, Aschoff P, Zuna I, Pfannenberg C, et al. Computed tomography, positron emission tomography, positron emission tomography/computed tomography, and magnetic resonance imaging for staging of limited pleural mesothelioma: initial results. Invest Radiol. 2008;43:737–44.CrossRefPubMed

18.

Jeong SY, Lee KS, Shin KM, Bae YA, Kim BT, Choe BK, et al. Efficacy of PET/CT in the characterization of solid or partly solid solitary pulmonary nodules. Lung Cancer. 2008;61:186–94.CrossRefPubMed

19.

Amthauer H, Denecke T, Rohlfing T, Ruf J, Bohmig M, Gutberlet M, et al. Value of image fusion using single photon emission computed tomography with integrated low dose computed tomography in comparison with a retrospective voxel-based method in neuroendocrine tumours. Eur Radiol. 2005;15:1456–62.CrossRefPubMed

20.

Gabriel M, Hausler F, Bale R, Moncayo R, Decristoforo C, Kovacs P, et al. Image fusion analysis of (99m)Tc-HYNIC-Tyr(3)-octreotide SPECT and diagnostic CT using an immobilisation device with external markers in patients with endocrine tumours. Eur J Nucl Med Mol Imaging. 2005;32:1440–51.CrossRefPubMed

21.

Tagliabue L, Schillaci O. SPECT/CT in oncology: the fusion of two imaging modalities is a new standard of care. Q J Nucl Med Mol Imaging. 2007;51:285–9.PubMed

Titel: SPECT/CT stabilizes the interpretation of somatostatin receptor scintigraphy findings: a retrospective analysis of inter-rater agreement
verfasst von: Ivayla Apostolova
Swantje Riethdorf
Ralph Buchert
Thorsten Derlin
Winfried Brenner
Janos Mester
Susanne Klutmann
Publikationsdatum: 01.07.2010
Verlag: Springer Japan
Erschienen in: Annals of Nuclear Medicine / Ausgabe 6/2010
Print ISSN: 0914-7187
Elektronische ISSN: 1864-6433
DOI: https://doi.org/10.1007/s12149-010-0383-9

Springer Medizin

Abstract

Objective

Methods

Results

Conclusion

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