Journal
CLINICAL NUCLEAR MEDICINE
Volume 44, Issue 1, Pages 1-3Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/RLU.0000000000002333
Keywords
Parkinson disease; parkinsonism; DaTscan; I-123-ioflupane; SPECT; SPECT/CT
Funding
- Competence Network of Heart Failure - Integrated Research and Treatment Center (IFB) of the Federal Ministry of Education and Research (BMBF)
- German Research Council (DFG) [HI 1789/3-3]
- European Union [701983]
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Purpose We aimed to (a) elucidate the concordance of visual assessment of an initial I-123-ioflupane scan by a human interpreter with comparison to results using a fully automatic semiquantitative method and (b) to assess the accuracy compared to follow-up (f/u) diagnosis established by movement disorder specialists. Methods An initial I-123-ioflupane scan was performed in 382 patients with clinically uncertain Parkinsonian syndrome. An experienced reader performed a visual evaluation of all scans independently. The findings of the visual read were compared with semiquantitative evaluation. In addition, available f/u clinical diagnosis (serving as a reference standard) was compared with results of the human read and the software. Results When comparing the semiquantitative method with the visual assessment, discordance could be found in 25 (6.5%) of 382 of the cases for the experienced reader (& = 0.868). The human observer indicated region of interest misalignment as the main reason for discordance. With neurology f/u serving as reference, the results of the reader revealed a slightly higher accuracy rate (87.7%, & = 0.75) compared to semiquantification (86.2%, & = 0.719, P < 0.001, respectively). No significant difference in the diagnostic performance of the visual read versus software-based assessment was found. Conclusions In comparison with a fully automatic semiquantitative method in I-123-ioflupane interpretation, human assessment obtained an almost perfect agreement rate. However, compared to clinical established diagnosis serving as a reference, visual read seemed to be slightly more accurate as a solely software-based quantitative assessment.
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