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. 2014 Aug;21(4):703-11.
doi: 10.1007/s12350-014-9895-3. Epub 2014 May 8.

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

Reza Arsanjani  1 , Sean W Hayes, Mathews Fish, Aryeh Shalev, Rine Nakanishi, Louise E J Thomson, John D Friedman, Guido Germano, Daniel S Berman, Piotr Slomka
Affiliations

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

Reza Arsanjani et al. J Nucl Cardiol. 2014 Aug.

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 (201)Tl/stress (99m)Tc-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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Figures

Figure 1
Figure 1
Diagnostic performance of expert readers using supine only versus supine/prone combined imaging in the entire population (n = 1181).
Figure 2
Figure 2
Diagnostic agreement between supine-only and combined supine/prone imaging.
Figure 3
Figure 3
Differences of visual summed stress scores between supine-only and combined supine/prone imaging in the entire population (n = 1181).
Figure 4
Figure 4
Differences of visual summed stress scores between supine-only and combined supine/prone imaging in males (n = 648).
Figure 5
Figure 5
Differences of visual summed stress scores between supine-only and combined supine/prone imaging in females (n = 533).
See this image and copyright information in PMC

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