title: Observer variability in the evaluation of dual-isotope Tl-201/Tc-99m sestamibi rest/stress myocardial perfusion SPECT in men and women with known or suspected stable angina pectoris.
abstract: BACKGROUND
  Observer variability of dual-isotope myocardial perfusion imaging (MPI) with single photon emission computed tomography has rarely been investigated. The aim of our study was to evaluate the interpretive reproducibility with this technique.
  
  
  RESULTS
  We report on 507 patients with known or suspected stable angina who were studied before coronary angiography. A 1-day thallium 201/technetium 99m sestamibi rest/stress MPI protocol was used. MPI was interpreted by 2 independent observers without knowledge of clinical data, using a 20-segment scoring model. By consensus, the overall rate of abnormal MPI was 49% (59% in men and 34% in women). The interobserver agreement for the whole group (kappa = 0.85) and for men and women separately (kappa = 0.86 and 0.82, respectively) was excellent with regard to the overall diagnosis (normal, reversible, or fixed defects) as well as left anterior descending and left circumflex artery vascular territories (kappa = 0.85 and 0.82, respectively). However, in the right coronary artery territory, agreement was excellent in men (kappa = 0.83) but moderate in women (kappa = 0.57).
  
  
  CONCLUSIONS
  In a relatively large group of men and women with stable angina pectoris, interpretive reproducibility (overall and individual vessel diagnosis) was excellent, except in the right coronary artery territory of women, in which it was moderate.
authors.affiliation: Department of Nuclear Medicine, Odense University Hospital, Sdr Boulevard 29, DK-5000 Odense C, Denmark. allan.johansen@dadlnet.dk
authors.forename: Allan
authors.initials: A
authors.lastname: Johansen
authors.forename: Poul Flemming
authors.initials: PF
authors.lastname: Høilund-Carlsen
authors.forename: Henrik Wulff
authors.initials: HW
authors.lastname: Christensen
authors.forename: Peter
authors.initials: P
authors.lastname: Grupe
authors.forename: Annegrete
authors.initials: A
authors.lastname: Veje
authors.forename: Werner
authors.initials: W
authors.lastname: Vach
authors.forename: Torben
authors.initials: T
authors.lastname: Haghfelt
mesh_terms: D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003718:Denmark / Q000453:epidemiology; D005080:Exercise Test / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012146:Rest; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D016037:Single-Blind Method; D013382:Subtraction Technique; D017256:Technetium Tc 99m Sestamibi; D013793:Thallium; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods / Q000706:statistics & numerical data*
chemical_list: D019275:Radiopharmaceuticals; C027549:thallium chloride; D017256:Technetium Tc 99m Sestamibi; D013793:Thallium