Equilibrium radionuclide angiography: Intra- and inter-observer repeatability and reproducibility in the assessment of cardiac systolic and diastolic function

Background This study aimed to assess intra- and inter-observer agreement in assessing the systolic and diastolic function with equilibrium radionuclide angiography (ERNA). Materials and methods Thirty-two adults underwent baseline and repeat ERNA. An experienced and a trainee operator analyzed the data by assigning regions of interest manually, fully automatically, and semi-automatically. The Bland-Altman statistic (mean +/- 1.96 standard deviations of the differences) was used to assess the repeatability (two different assessments of a single acquisition) and reproducibility (assessments of two different acquisitions). Results Using the semi-automated technique the intraobserver repeatability and reproducibility of left ventricular ejection fraction for the experienced physician were - 0.1 +/- 3.7 and 0.0 +/- 3.8 and for the trainee 2.2 +/- 10.6 and 1.9 +/- 8.4, respectively. The inter-observer repeatability and reproducibility were - 1.8 +/- 6.4 and 0.4 +/- 9.0, respectively. Among the parameters of diastolic function, the intraobserver repeatability and reproducibility of the peak filling rate for the experienced physician were - 0.0 +/- 1.1 and - 0.1 +/- 1.1 and for the trainee 0.2 +/- 3.5 and 0.4 +/- 3.7, respectively. The inter-observer repeatability and reproducibility were 0.3 +/- 1.5 and 0.5 +/- 4.0, respectively. Similar was the pattern for the other diastolic indices. In all cases the limits of agreement varied according to the quantification approach. Conclusion A good repeatability but a moderate reproducibility was found in the assessment of the LVEF. Less good were the findings in the assessment of diastolic function.

Automated summary

The study found good repeatability but moderate reproducibility in the assessment of LVEF. In contrast, the findings for diastolic function assessment were less impressive.