Visual assessment of left ventricular perfusion and function with electrocardiography-gated SPECT has high intraobserver and the interobserver reproducibility among experienced nuclear cardiologists and cardiology trainees

Peter G. Danias, Alan W. Ahlberg, Mark I. Travin, Nicholas C. Mahr, Joseph E. Abreu, Dominic Marini, April Mann, Jeffrey F. Mather, William E. Boden, Gary V. Heller

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background. Stress electrocardiography (ECG)-gated single photon emission computed tomography (SPECT) for assessment of left ventricular perfusion and function improves the confidence of interpretation and enhances specificity for detection of coronary artery disease. The reproducibility of visual interpretation of ECG-gated SPECT images and the significance of training and experience have not been reported previously in a large series of consecutive patients. We evaluated both intraobserver and interobserver agreement of interpretation of ECG-gated SPECT images among 3 cardiology trainees and 3 experienced nuclear cardiologists from 3 institutions. Methods and Results. Three nuclear cardiologists and 3 cardiology trainees who had fulfilled American College of Cardiology/American Society of Nuclear Cardiology Core Cardiology Training Symposium (ACC/ASNC COCATS) guidelines for level II training in nuclear cardiology independently evaluated 106 consecutive technetium 99m sestamibi SPECT images with ECG gating of either the stress or rest images. All cases were interpreted blindly, twice in random sequence, without clinical data. We assessed intraobserver and interobserver agreement for myocardial perfusion, left ventricular regional and global systolic function, and overall clinical impression, by means of percent agreement and Cohen's κ statistic. Intraobserver agreement was good (82%-92%, κ = 0.54-0.84) for assessment of myocardial perfusion, systolic function, and overall impression. Interobserver agreement was also good, ranging from 65% to 90% (κ = 0.32-0.76), with better agreement found for assessment of function (77%-85%, κ = 0.52-0.7) than for perfusion (65%-80%, κ = 0.32-0.6). For all measures, there were no significant differences in reproducibility between nuclear cardiologists and cardiology trainees. Conclusions. Interpretation of ECG-gated SPECT images has high reproducibility and agreement among both nuclear cardiologists and cardiology trainees.

Original languageEnglish (US)
Pages (from-to)263-270
Number of pages8
JournalJournal of Nuclear Cardiology
Volume9
Issue number3
DOIs
StatePublished - May 2002

Fingerprint

Single-Photon Emission-Computed Tomography
Cardiology
Left Ventricular Function
Electrocardiography
Perfusion
Technetium Tc 99m Sestamibi
Cardiologists
Coronary Artery Disease
Guidelines

Keywords

  • Interobserver agreement
  • Intraobserver agreement
  • Reproducibility
  • Single photon emission computed tomography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Visual assessment of left ventricular perfusion and function with electrocardiography-gated SPECT has high intraobserver and the interobserver reproducibility among experienced nuclear cardiologists and cardiology trainees. / Danias, Peter G.; Ahlberg, Alan W.; Travin, Mark I.; Mahr, Nicholas C.; Abreu, Joseph E.; Marini, Dominic; Mann, April; Mather, Jeffrey F.; Boden, William E.; Heller, Gary V.

In: Journal of Nuclear Cardiology, Vol. 9, No. 3, 05.2002, p. 263-270.

Research output: Contribution to journalArticle

Danias, Peter G. ; Ahlberg, Alan W. ; Travin, Mark I. ; Mahr, Nicholas C. ; Abreu, Joseph E. ; Marini, Dominic ; Mann, April ; Mather, Jeffrey F. ; Boden, William E. ; Heller, Gary V. / Visual assessment of left ventricular perfusion and function with electrocardiography-gated SPECT has high intraobserver and the interobserver reproducibility among experienced nuclear cardiologists and cardiology trainees. In: Journal of Nuclear Cardiology. 2002 ; Vol. 9, No. 3. pp. 263-270.
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abstract = "Background. Stress electrocardiography (ECG)-gated single photon emission computed tomography (SPECT) for assessment of left ventricular perfusion and function improves the confidence of interpretation and enhances specificity for detection of coronary artery disease. The reproducibility of visual interpretation of ECG-gated SPECT images and the significance of training and experience have not been reported previously in a large series of consecutive patients. We evaluated both intraobserver and interobserver agreement of interpretation of ECG-gated SPECT images among 3 cardiology trainees and 3 experienced nuclear cardiologists from 3 institutions. Methods and Results. Three nuclear cardiologists and 3 cardiology trainees who had fulfilled American College of Cardiology/American Society of Nuclear Cardiology Core Cardiology Training Symposium (ACC/ASNC COCATS) guidelines for level II training in nuclear cardiology independently evaluated 106 consecutive technetium 99m sestamibi SPECT images with ECG gating of either the stress or rest images. All cases were interpreted blindly, twice in random sequence, without clinical data. We assessed intraobserver and interobserver agreement for myocardial perfusion, left ventricular regional and global systolic function, and overall clinical impression, by means of percent agreement and Cohen's κ statistic. Intraobserver agreement was good (82{\%}-92{\%}, κ = 0.54-0.84) for assessment of myocardial perfusion, systolic function, and overall impression. Interobserver agreement was also good, ranging from 65{\%} to 90{\%} (κ = 0.32-0.76), with better agreement found for assessment of function (77{\%}-85{\%}, κ = 0.52-0.7) than for perfusion (65{\%}-80{\%}, κ = 0.32-0.6). For all measures, there were no significant differences in reproducibility between nuclear cardiologists and cardiology trainees. Conclusions. Interpretation of ECG-gated SPECT images has high reproducibility and agreement among both nuclear cardiologists and cardiology trainees.",
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T1 - Visual assessment of left ventricular perfusion and function with electrocardiography-gated SPECT has high intraobserver and the interobserver reproducibility among experienced nuclear cardiologists and cardiology trainees

AU - Danias, Peter G.

AU - Ahlberg, Alan W.

AU - Travin, Mark I.

AU - Mahr, Nicholas C.

AU - Abreu, Joseph E.

AU - Marini, Dominic

AU - Mann, April

AU - Mather, Jeffrey F.

AU - Boden, William E.

AU - Heller, Gary V.

PY - 2002/5

Y1 - 2002/5

N2 - Background. Stress electrocardiography (ECG)-gated single photon emission computed tomography (SPECT) for assessment of left ventricular perfusion and function improves the confidence of interpretation and enhances specificity for detection of coronary artery disease. The reproducibility of visual interpretation of ECG-gated SPECT images and the significance of training and experience have not been reported previously in a large series of consecutive patients. We evaluated both intraobserver and interobserver agreement of interpretation of ECG-gated SPECT images among 3 cardiology trainees and 3 experienced nuclear cardiologists from 3 institutions. Methods and Results. Three nuclear cardiologists and 3 cardiology trainees who had fulfilled American College of Cardiology/American Society of Nuclear Cardiology Core Cardiology Training Symposium (ACC/ASNC COCATS) guidelines for level II training in nuclear cardiology independently evaluated 106 consecutive technetium 99m sestamibi SPECT images with ECG gating of either the stress or rest images. All cases were interpreted blindly, twice in random sequence, without clinical data. We assessed intraobserver and interobserver agreement for myocardial perfusion, left ventricular regional and global systolic function, and overall clinical impression, by means of percent agreement and Cohen's κ statistic. Intraobserver agreement was good (82%-92%, κ = 0.54-0.84) for assessment of myocardial perfusion, systolic function, and overall impression. Interobserver agreement was also good, ranging from 65% to 90% (κ = 0.32-0.76), with better agreement found for assessment of function (77%-85%, κ = 0.52-0.7) than for perfusion (65%-80%, κ = 0.32-0.6). For all measures, there were no significant differences in reproducibility between nuclear cardiologists and cardiology trainees. Conclusions. Interpretation of ECG-gated SPECT images has high reproducibility and agreement among both nuclear cardiologists and cardiology trainees.

AB - Background. Stress electrocardiography (ECG)-gated single photon emission computed tomography (SPECT) for assessment of left ventricular perfusion and function improves the confidence of interpretation and enhances specificity for detection of coronary artery disease. The reproducibility of visual interpretation of ECG-gated SPECT images and the significance of training and experience have not been reported previously in a large series of consecutive patients. We evaluated both intraobserver and interobserver agreement of interpretation of ECG-gated SPECT images among 3 cardiology trainees and 3 experienced nuclear cardiologists from 3 institutions. Methods and Results. Three nuclear cardiologists and 3 cardiology trainees who had fulfilled American College of Cardiology/American Society of Nuclear Cardiology Core Cardiology Training Symposium (ACC/ASNC COCATS) guidelines for level II training in nuclear cardiology independently evaluated 106 consecutive technetium 99m sestamibi SPECT images with ECG gating of either the stress or rest images. All cases were interpreted blindly, twice in random sequence, without clinical data. We assessed intraobserver and interobserver agreement for myocardial perfusion, left ventricular regional and global systolic function, and overall clinical impression, by means of percent agreement and Cohen's κ statistic. Intraobserver agreement was good (82%-92%, κ = 0.54-0.84) for assessment of myocardial perfusion, systolic function, and overall impression. Interobserver agreement was also good, ranging from 65% to 90% (κ = 0.32-0.76), with better agreement found for assessment of function (77%-85%, κ = 0.52-0.7) than for perfusion (65%-80%, κ = 0.32-0.6). For all measures, there were no significant differences in reproducibility between nuclear cardiologists and cardiology trainees. Conclusions. Interpretation of ECG-gated SPECT images has high reproducibility and agreement among both nuclear cardiologists and cardiology trainees.

KW - Interobserver agreement

KW - Intraobserver agreement

KW - Reproducibility

KW - Single photon emission computed tomography

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