title: Interobserver variation in diagnosis of dementia by brain perfusion SPECT.
abstract: Brain perfusion SPECT (BP-SPECT) has characteristic patterns of abnormality, enabling the differential diagnosis of dementia. The purpose of this study was to measure interobserver variations in the diagnosis of dementia using BP-SPECT. BP-SPECT images of 57 cases, 19 of Alzheimer's disease (AD), eight of multi-infarct dementia (MID), three of Pick's disease, five of other dementias, and 22 normal controls, were interpreted by ten nuclear medicine physicians with varying levels of experience. Brain MR images of the cases were then interpreted apart from SPECT. The physicians independently rated all of the diagnoses listed beforehand according to a five-point scale, with clinical information provided. Receiver-operating characteristic (ROC) curves and the area under the ROC curve (Az) were calculated. Az varied from 0.48 to 0.87. Mean Az's were significantly larger (p<0.05) in the diagnosis by SPECT than in that by MRI (0.715 and 0.629 for dementia vs. normal, 0.670 and 0.560 for AD or MID vs. normal, 0.610 and 0.416 for AD vs. normal, and 0.672 and 0.412 for AD vs. MID, respectively). Considerable interobserver variation was present in BP-SPECT interpretation. BP-SPECT may be more effective for the evaluation of dementia than MRI when the same nuclear medicine physicians interpret both images.
authors.affiliation: Department of Radiology, Saitama Medical Center, Saitama Medical School, Kawagoe, Japan.
authors.forename: Norinari
authors.initials: N
authors.lastname: Honda
authors.forename: Kikuo
authors.initials: K
authors.lastname: Machida
authors.forename: Makoto
authors.initials: M
authors.lastname: Hosono
authors.forename: Tohru
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsuda
authors.forename: Motoo
authors.initials: M
authors.lastname: Oshima
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Koizumi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kosuda
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Momose
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Mori
authors.forename: Jun
authors.initials: J
authors.lastname: Hashimoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000000981:diagnostic imaging; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D003545:Cysteine / Q000031:analogs & derivatives*; D003704:Dementia / Q000175:diagnosis / Q000000981:diagnostic imaging*; D015161:Dementia, Multi-Infarct / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D020367:Iofetamine; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015609:Organotechnetium Compounds; D010477:Perfusion; D012372:ROC Curve; D011859:Radiography; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D020367:Iofetamine; C059659:technetium Tc 99m bicisate; D003545:Cysteine