Inter-reader agreement and additive benefit of SPECT or SPECT/CT modality with [99mTc]Tc-pertechnetate scintigraphy imaging for the assessment of thyroid nodules in a tertiary care center
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View abstract on PubMed
Summary
This summary is machine-generated.SPECT/CT imaging shows limited additive benefit for initial thyroid nodule evaluation, particularly in primary care settings. Experienced physicians may refer more complex cases, but overall clinical impact remains minimal for most patients.
Area Of Science
- Nuclear Medicine
- Radiology
- Endocrinology
Background
- Thyroid nodules (TN) are prevalent, with ultrasound (US) findings like TI-RADS aiming to predict malignancy risk.
- Concerns exist regarding the reliability and reproducibility of US-based TI-RADS categorization.
- Advancements in SPECT/CT technology offer potential for improved thyroid nodule assessment.
Purpose Of The Study
- To evaluate the additive value of SPECT/CT imaging in the initial assessment of complex thyroid nodules.
- To analyze the impact of SPECT/CT on multinodular goiter and difficult-to-characterize solitary nodules.
- To assess inter-reader agreement for SPECT/CT interpretation in thyroid nodule evaluation.
Main Methods
- Retrospective analysis of 61 patients with incidental TN undergoing planar thyroid scan and SPECT/CT.
- Three readers with varied experience evaluated nodule functionality, TI-RADS, and SPECT/CT's additive benefit.
- Inter-reader agreement (IRA) assessed using Kappa values, with specific interpretations for agreement levels.
Main Results
- Nodule match rate among readers was almost perfect (k=0.81).
- Inter-reader agreement for ACR TI-RADS was moderate (k=0.47), while for patient referral it was substantial (k=0.60).
- Inter-reader agreement for nodule functionality was good (k=0.68), with only slightly lower scores involving less experienced readers.
Conclusions
- SPECT/CT imaging offers limited additive clinical benefit for the majority of patients with thyroid nodules.
- Increased physician experience correlates with higher SPECT/CT referral rates, but not necessarily greater overall benefit.
- SPECT/CT may be more suitable for tertiary care centers; its additive benefit at the primary care level is negligible.
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