title: Interobserver variability of cerebral blood flow measurements obtained using spectral analysis and technetium-99m labeled compounds.
abstract: Radionuclide angiography with technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO) or technetium-99m ethyl cysteinate dimer (99mTc-ECD) enables the non-invasive estimation of absolute cerebral blood flow (CBF) to be determined by using spectral analysis (SA). We previously demonstrated the clinical use of SA; however, this method involves a few manual steps. The aim of this study was to evaluate the interobserver variability of CBF estimations made using SA and compare these results with those obtained by using graphical analysis (GA). In twenty patients with various brain diseases (27-74 years old), radionuclide angiography examinations were performed using 99mTc-labeled compounds (10 patients, 99mTc-HMPAO; 10 patients, 99mTc-ECD). Bilateral cerebral hemispheres were studied in all patients, and the brain perfusion index (BPI) values were estimated using SA and GA. The interobserver variability between two observers was then assessed. A good correlation between the BPI values assessed using both SA (BPI(S)) and GA (BPI(G)) was obtained. The correlation coefficient for BPI(S) (r = 0.987) was almost the same as that for BPI(G) (r = 0.982). The degree of interobserver variability was not affected by the measurement of elevated BPI values. Measurements carried out by two observers using both SA and GA exhibited a similar degree of interobserver variability. SA appears to have a satisfactory interobserver variability and may be more suitable for clinical applications.
authors.affiliation: Division of Strokology, Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Suita, Japan. tkswm@medone.med.osaka-u.ac.jp
authors.forename: Masashi
authors.initials: M
authors.lastname: Takasawa
authors.forename: Kenya
authors.initials: K
authors.lastname: Murase
authors.forename: Naohiko
authors.initials: N
authors.lastname: Oku
authors.forename: Minoru
authors.initials: M
authors.lastname: Kawamata
authors.forename: Makoto
authors.initials: M
authors.lastname: Nagayoshi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Osaki
authors.forename: Masao
authors.initials: M
authors.lastname: Imaizumi
authors.forename: Takuya
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Hori
authors.forename: Jun
authors.initials: J
authors.lastname: Hatazawa
mesh_terms: D000465:Algorithms; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging*; D001927:Brain Diseases / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation; D003545:Cysteine / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D019690:Technetium Tc 99m Exametazime
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; C059659:technetium Tc 99m bicisate; D003545:Cysteine