title: [Diagnostic accuracy of 201T1 SPECT.MRI in brain diseases and inter-reader variance of diagnostic performance].
abstract: Fifteen-four studies of 201T1 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 (SEP), and sensitivity and specificity for malignancy of 201T1 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 201T1 brain tumor SPECT has moderate sensitivity and specificity for malignancy, which is not improved by addition of anatomical reference 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.
authors.affiliation: Saitama Medical Center, Saitama Medical School.
authors.forename: K
authors.initials: K
authors.lastname: Machida
authors.forename: N
authors.initials: N
authors.lastname: Honda
authors.forename: T
authors.initials: T
authors.lastname: Matsumoto
authors.forename: N
authors.initials: N
authors.lastname: Yui
authors.forename: T
authors.initials: T
authors.lastname: Togawa
authors.forename: A
authors.initials: A
authors.lastname: Kubo
authors.forename: Y
authors.initials: Y
authors.lastname: Tsukatani
authors.forename: H
authors.initials: H
authors.lastname: Oyamada
authors.forename: K
authors.initials: K
authors.lastname: Ishii
authors.forename: H
authors.initials: H
authors.lastname: Nishimaki
authors.forename: Y
authors.initials: Y
authors.lastname: Mori
authors.forename: K
authors.initials: K
authors.lastname: Uno
authors.forename: H
authors.initials: H
authors.lastname: Murata
authors.forename: H
authors.initials: H
authors.lastname: Maruno
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012372:ROC Curve; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon / Q000706:statistics & numerical data
chemical_list: D013794:Thallium Radioisotopes