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.
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.
Johansen
Allan
A
Department of Nuclear Medicine, Odense University Hospital, Sdr Boulevard 29, DK-5000 Odense C, Denmark. allan.johansen@dadlnet.dk
Høilund-Carlsen
Poul Flemming
PF
Christensen
Henrik Wulff
HW
Grupe
Peter
P
Veje
Annegrete
A
Vach
Werner
W
Haghfelt
Torben
T
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*
D019275:Radiopharmaceuticals; C027549:thallium chloride; D017256:Technetium Tc 99m Sestamibi; D013793:Thallium