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Interobserver variation of angioscintigraphy for deep vein thrombosis.
S Fløistrup1, T Gjørup, S L Nielsen
1Department of Clinical Physiology & Nuclear Medicine, University of Copenhagen, Herlev Hospital, Denmark.
Scandinavian Journal of Clinical and Laboratory Investigation
|December 1, 1987
Summary
Angioscintigraphy is a safe diagnostic tool for deep vein thrombosis (DVT). Its accuracy in detecting DVT is comparable to radiographic phlebography, offering a low-risk alternative for patients.
Area of Science:
- Nuclear Medicine
- Vascular Imaging
- Diagnostic Accuracy
Background:
- Deep vein thrombosis (DVT) is a significant clinical concern.
- Accurate and safe diagnostic methods are crucial for DVT management.
- Radiographic phlebography, a common diagnostic tool, carries risks and inconveniences.
Purpose of the Study:
- To evaluate the diagnostic accuracy and interobserver agreement of angioscintigraphy for deep vein thrombosis.
- To compare angioscintigraphy with radiographic phlebography as a diagnostic alternative.
Main Methods:
- 119 patients with suspected DVT underwent leg deep vein angioscintigraphy.
- Two nuclear medicine specialists independently interpreted the angioscintigrams.
- Key findings assessed included focal-filling defects, increased tissue activity, and collaterals.
- Interobserver agreement was quantified using kappa values after adjusting for chance agreement.
Main Results:
- Overall agreement for assessed findings ranged from 0.74 to 0.84.
- Adjusted kappa values indicated moderate agreement for most findings (0.47-0.64), with lower agreement for collaterals (0.21).
- Interobserver variation was found to be comparable to that of radiographic phlebography.
Conclusions:
- Angioscintigraphy demonstrates a relevant diagnostic utility for deep vein thrombosis.
- The technique offers a diagnostic alternative with minimal risk and inconvenience to patients.
- Further validation may enhance its role in DVT diagnosis.