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Inter-observer reproducibility of relative 99Tcm-DMSA uptake
M Tondeur1, K Melis, C De Sadeleer
1Department of Radioisotopes, Free Universities of Brussels (ULB-VUB), Belgium. mariannetondeur@yahoo.com
Nuclear Medicine Communications
|June 30, 2000
Summary
Inter-observer variability in renal uptake assessment using 99Tcm-DMSA planar imaging was evaluated. While generally low, variability increased in adults, influenced by signal-to-noise ratio and kidney asymmetry, suggesting program influence.
Area of Science:
- Nuclear Medicine
- Radiopharmacology
- Medical Imaging Analysis
Background:
- Renal uptake quantification using technetium-99m dimercaptosuccinic acid (99Tcm-DMSA) planar imaging is crucial for assessing kidney function.
- Inter-observer variability in image analysis can impact diagnostic accuracy and treatment decisions.
Purpose of the Study:
- To assess the inter-observer variability in the calculation of relative renal uptake from 99Tcm-DMSA planar images.
- To identify factors contributing to variability in uptake measurements.
Main Methods:
- 15 physicians analyzed 99Tcm-DMSA planar images from 49 patients (10 adults, 39 children).
- Participants calculated relative renal uptake using their routine software.
- Inter-observer variability was quantified using maximum difference and standard deviation of left renal uptake.
Main Results:
- Left renal uptake ranged from 29.0% to 72.0% (mean 49.8%).
- Maximum differences in uptake were typically below 8% (mean 4.5%).
- Standard deviations were significantly higher in adults (2.05) than children (1.12), correlating with signal-to-noise ratio and kidney asymmetry.
Conclusions:
- 99Tcm-DMSA uptake measurements show acceptable inter-observer agreement in most cases.
- Variability is influenced by image quality (signal-to-noise) and kidney asymmetry, particularly in adults.
- Systematic differences suggest potential influence of specific calculation programs used by observers.