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18FDG uptake in brown fat: potential for false positives.

https://arctichealth.org/en/permalink/ahliterature77628
Source
Radiol Technol. 2007 May-Jun;78(5):361-6
Publication Type
Article
Author
Evans Kevin D
Tulloss Timothy A
Hall Nathan
Author Affiliation
Radiologic Sciences and Therapy, Division of the School of Allied Medical Professions and the Department of Radiology at the Ohio State University, Columbus, OH, USA.
Source
Radiol Technol. 2007 May-Jun;78(5):361-6
Language
English
Publication Type
Article
Keywords
Adipose Tissue, Brown - metabolism - radionuclide imaging
Artifacts
False Positive Reactions
Fluorodeoxyglucose F18 - diagnostic use - pharmacokinetics
Humans
Neoplasms - metabolism - radionuclide imaging
Radiopharmaceuticals - diagnostic use - pharmacokinetics
Abstract
CONTEXT: (18)FDG is used widely to enhance PET and PET-CT images. However, this radiotracer tends to be taken up by brown fat, which can lead to false-positive diagnoses. Purpose To determine which patients, areas of the body and circumstances are more likely to be associated with false-positive diagnoses due to (18)FDG uptake in brown fat. METHOD: A review of the literature was conducted on factors that contribute to false-positive diagnoses caused by (18)FDG uptake in brown fat. RESULTS: Brown fat commonly is found in women and children and can be located in the supraclavicular, mediastinal, paravertebral and perirenal areas of the body. Research has shown that these areas can be sources of a false-positive diagnosis because of (18)FDG uptake. Studies also have indicated that cold climate affects the uptake of (18)FDG, contributing to false-positive results on PET-CT examinations. CONCLUSIONS: This literature review should stimulate continued research into and awareness of the potential for false-positive PET findings in women and children during the winter months and in cold climates. This information is especially applicable to young female patients undergoing PET or PET-CT.
PubMed ID
17519372 View in PubMed
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18F-FDG PET imaging of myocardial viability in an experienced center with access to 18F-FDG and integration with clinical management teams: the Ottawa-FIVE substudy of the PARR 2 trial.

https://arctichealth.org/en/permalink/ahliterature144812
Source
J Nucl Med. 2010 Apr;51(4):567-74
Publication Type
Article
Date
Apr-2010
Author
Arun Abraham
Graham Nichol
Kathryn A Williams
Ann Guo
Robert A deKemp
Linda Garrard
Ross A Davies
Lloyd Duchesne
Haissam Haddad
Benjamin Chow
Jean DaSilva
Rob S B Beanlands
Author Affiliation
National Cardiac PET Centre and Division of Cardiology, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Source
J Nucl Med. 2010 Apr;51(4):567-74
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Canada
Coronary Artery Disease - physiopathology - radionuclide imaging
Female
Fluorodeoxyglucose F18 - diagnostic use
Heart - physiopathology - radionuclide imaging
Heart Failure - physiopathology - radionuclide imaging
Humans
Male
Middle Aged
Myocardial Revascularization
Patient care team
Positron-Emission Tomography
Professional Competence
Radiopharmaceuticals - diagnostic use
Randomized Controlled Trials as Topic
Survival Analysis
Tissue Survival
Ventricular Dysfunction, Left - physiopathology - radionuclide imaging
Abstract
(18)F-FDG PET may assist decision making in ischemic cardiomyopathy. The PET and Recovery Following Revascularization (PARR 2) trial demonstrated a trend toward beneficial outcomes with PET-assisted management. The substudy of PARR 2 that we call Ottawa-FIVE, described here, was a post hoc analysis to determine the benefit of PET in a center with experience, ready access to (18)F-FDG, and integration with clinical teams.
Included were patients with left ventricular dysfunction and suspected coronary artery disease being considered for revascularization. The patients had been randomized in PARR 2 to PET-assisted management (group 1) or standard care (group 2) and had been enrolled in Ottawa after August 1, 2002 (the date that on-site (18)F-FDG was initiated) (n = 111). The primary outcome was the composite endpoint of cardiac death, myocardial infarction, or cardiac rehospitalization within 1 y. Data were compared with the rest of PARR 2 (PET-assisted management [group 3] or standard care [group 4]).
In the Ottawa-FIVE subgroup of PARR 2, the cumulative proportion of patients experiencing the composite event was 19% (group 1), versus 41% (group 2). Multivariable Cox proportional hazards regression showed a benefit for the PET-assisted strategy (hazard ratio, 0.34; 95% confidence interval, 0.16-0.72; P = 0.005). Compared with other patients in PARR 2, Ottawa-FIVE patients had a lower ejection fraction (25% +/- 7% vs. 27% +/- 8%, P = 0.04), were more often female (24% vs. 13%, P = 0.006), tended to be older (64 +/- 10 y vs. 62 +/- 10 y, P = 0.07), and had less previous coronary artery bypass grafting (13% vs. 21%, P = 0.07). For patients in the rest of PARR 2, there was no significant difference in events between groups 3 and 4. The observed effect of (18)F-FDG PET-assisted management in the 4 groups in the context of adjusted survival curves demonstrated a significant interaction (P = 0.016). Comparisons of the 2 arms in Ottawa-FIVE to the 2 arms in the rest of PARR 2 demonstrated a trend toward significance (standard care, P = 0.145; PET-assisted management, P = 0.057).
In this post hoc group analysis, a significant reduction in cardiac events was observed in patients with (18)F-FDG PET-assisted management, compared with patients who received standard care. The results suggest that outcome may be benefited using (18)F-FDG PET in an experienced center with ready access to (18)F-FDG and integration with imaging, heart failure, and revascularization teams.
Notes
Comment In: J Nucl Med. 2010 Apr;51(4):505-620237024
PubMed ID
20237039 View in PubMed
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Additive value of nuclear medicine shuntograms to computed tomography for suspected cerebrospinal fluid shunt obstruction in the pediatric emergency department.

https://arctichealth.org/en/permalink/ahliterature147029
Source
Pediatr Emerg Care. 2009 Dec;25(12):827-30
Publication Type
Article
Date
Dec-2009
Author
David Ouellette
Timothy Lynch
Eric Bruder
Edward Everson
Gary Joubert
Jamie A Seabrook
Rodrick K Lim
Author Affiliation
Division of Emergency Medicine, Department of Medicine, University of Western Ontario, London, Ontario, Canada.
Source
Pediatr Emerg Care. 2009 Dec;25(12):827-30
Date
Dec-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Cerebral Ventriculography - instrumentation
Cerebrospinal Fluid Shunts - adverse effects
Child
Child, Preschool
Equipment Failure
Female
Humans
Hydrocephalus - radiography - radionuclide imaging - surgery
Infant
Male
Ontario
Radiopharmaceuticals - diagnostic use
Retrospective Studies
Sensitivity and specificity
Technetium Tc 99m Pentetate - diagnostic use
Tomography, X-Ray Computed
Abstract
To measure the predictive value of nuclear medicine studies (cerebrospinal fluid [CSF] shuntograms) and radiographic studies (computed tomographic [CT] scans) in a cohort of children undergoing evaluation for suspected shunt obstruction in a tertiary care pediatric emergency department (ED).
A retrospective chart review was conducted on patients younger than 18 years who presented to the pediatric ED of the Children's Hospital of Western Ontario and had both CT of the head and a CSF shuntogram ordered by the attending pediatric emergency medicine physician between December 1998 and April 2003 because of suspected shunt obstruction.
A total of 69 patients were evaluated for suspected shunt obstruction in the ED during this period with both a CT and a CSF shuntogram. Twenty-seven patients (39.1%) subsequently required corrective surgery for suspected shunt obstruction that was confirmed intraoperatively. The CT scans showed abnormalities suggestive of CSF shunt obstruction in 21 of the patients who required surgery (sensitivity, 77.8%; negative predictive value, 82.4%), whereas the CSF shuntograms showed abnormalities suggestive of CSF obstruction in 25 of the patients who required surgery (sensitivity, 92.6%; negative predictive value, 92.6%). The CT scans and the shuntograms combined revealed abnormalities suggestive of CSF shunt obstruction in 26 of the 27 patients who required surgery (sensitivity, 96.3%; negative predictive value, 97.4%).
Over one third of pediatric ED patients evaluated with CT and CSF shuntograms required surgical management. Sensitivity was increased with CT and CSF shuntogram compared with CT alone. Prospective studies are required to assess the use of radiographic and nuclear medicine tests for the shunt evaluation in conjunction with the development of a clinical prediction rule for the pediatric emergency physician.
PubMed ID
19952974 View in PubMed
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The Alzheimer's disease neuroimaging initiative.

https://arctichealth.org/en/permalink/ahliterature170981
Source
Neuroimaging Clin N Am. 2005 Nov;15(4):869-77, xi-xii
Publication Type
Article
Date
Nov-2005
Author
Susanne G Mueller
Michael W Weiner
Leon J Thal
Ronald C Petersen
Clifford Jack
William Jagust
John Q Trojanowski
Arthur W Toga
Laurel Beckett
Author Affiliation
Department of Radiology, University of California, San Francisco, CA, USA.
Source
Neuroimaging Clin N Am. 2005 Nov;15(4):869-77, xi-xii
Date
Nov-2005
Language
English
Publication Type
Article
Keywords
Aged
Alzheimer Disease - diagnosis
Biological Markers
Brain - pathology
Canada
Fluorodeoxyglucose F18 - diagnostic use
Humans
Magnetic Resonance Imaging - methods
Positron-Emission Tomography - methods
Radiopharmaceuticals - diagnostic use
United States
Abstract
With increasing life expectancy in developed countries, the incidence of Alzheimer's disease (AD) and its socioeconomic impact are growing. Increasing knowledge of the mechanisms of AD facilitates the development of treatment strategies aimed at slowing down or preventing neuronal death. AD treatment trials using clinical outcome measures require long observation times and large patient samples. There is increasing evidence that neuroimaging and cerebrospinal fluid and blood biomarkers may provide information that may reduce sample sizes and observation periods. The Alzheimer's Disease Neuroimaging Initiative will help identify clinical, neuroimaging, and biomarker outcome measures that provide the highest power for measurement of longitudinal changes and for prediction of transitions.
Notes
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PubMed ID
16443497 View in PubMed
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Bone imaging in advanced gastric cancer.

https://arctichealth.org/en/permalink/ahliterature4012
Source
Clin Nucl Med. 1998 Jun;23(6):384
Publication Type
Article
Date
Jun-1998

Can nuclear medicine technologists assess whether a myocardial perfusion rest study is required?

https://arctichealth.org/en/permalink/ahliterature91262
Source
J Nucl Med Technol. 2008 Dec;36(4):181-5
Publication Type
Article
Date
Dec-2008
Author
Johansson Lena
Lomsky Milan
Gjertsson Peter
Sallerup-Reid Maria
Johansson Johanna
Ahlin Nils-Göran
Edenbrandt Lars
Author Affiliation
Department of Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden. lena.bi.johansson@vgregion.se
Source
J Nucl Med Technol. 2008 Dec;36(4):181-5
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Exercise Test - statistics & numerical data
Humans
Middle Aged
Myocardial Infarction - complications - radionuclide imaging
Observer Variation
Prevalence
Professional Competence - statistics & numerical data
Radiopharmaceuticals - diagnostic use
Reproducibility of Results
Rest
Sensitivity and specificity
Sweden - epidemiology
Technetium Tc 99m Sestamibi - diagnostic use
Tomography, Emission-Computed, Single-Photon - statistics & numerical data
Ventricular Dysfunction, Left - complications - radionuclide imaging
Abstract
Both stress and rest imaging are usually performed to diagnose ischemia or infarction in the left ventricle. If the stress study is performed first and the images indicate normal findings, it might be unnecessary to perform the rest study. The current study determines whether nuclear medicine technologists can assess the necessity of a rest study. METHODS: The results of gated SPECT performed using a 2-d nongated stress and gated rest (99m)Tc-sestamibi protocol for 532 consecutive patients were studied. Myocardial perfusion imaging was performed for diagnosing coronary artery disease (CAD) in 421 patients and for managing known CAD in 107 patients; 4 patients were examined for other reasons. Seventy-nine patients had previous myocardial infarction. Visual interpretation by 1 experienced physician at the time of clinical reporting was used as the gold standard for determining the scintigraphic presence of myocardial infarction or ischemia; rest, stress, and gated rest images and clinical information were available to this physician. All cases categorized as infarction or ischemia present or probably present were categorized as the group requiring a rest study (i.e., the "rest-study-required group"), whereas all other cases were categorized as the group not requiring a rest study (i.e., the "no-rest-study-required group"). A total of 3 physicians and 3 technologists independently interpreted the nongated stress images (slice images and polar plots) and decided whether a rest study was required. RESULTS: In the rest-study-required group, the 3 technologists correctly classified on average 171 of the 172 cases, and the 3 physicians correctly classified 169 (a difference that was not statistically significant). In the no-rest-study-required group, the physicians correctly classified 32% and the technologists 21% of the cases (P = 0.001). The risk that a patient sent home without a rest study would have been diagnosed with infarction or ischemia using the combined stress-rest interpretation was 1.3% (1/75) for the technologists and 2.6% (3/115) for the physicians. CONCLUSION: The nuclear medicine technologists were able to assess whether a rest study was needed; the risk that this assessment would be incorrect was not higher for the technologists than it was for the physicians. This type of assessment by a nuclear medicine technologist could be of value in efforts to improve effectiveness at a nuclear medicine clinic.
PubMed ID
19008292 View in PubMed
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Can preoperative myocardial perfusion scintigraphy predict changes in left ventricular perfusion and function after coronary artery bypass graft surgery?

https://arctichealth.org/en/permalink/ahliterature125498
Source
Interact Cardiovasc Thorac Surg. 2012 Jun;14(6):779-84
Publication Type
Article
Date
Jun-2012
Author
Rozy Eckardt
Bo Juel Kjeldsen
Allan Johansen
Peter Grupe
Torben Haghfelt
Per Thayssen
Lars Ib Andersen
Birger Hesse
Author Affiliation
Department of Cardiothoracic Surgery, Institute of Clinical Research, Odense University Hospital, Odense, Denmark. rozy@eckardtmail.dk
Source
Interact Cardiovasc Thorac Surg. 2012 Jun;14(6):779-84
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Aged
Angina Pectoris - physiopathology - radionuclide imaging - surgery
Coronary Angiography
Coronary Artery Bypass - adverse effects
Coronary Artery Disease - physiopathology - radionuclide imaging - surgery
Coronary Circulation
Denmark
Female
Humans
Male
Middle Aged
Myocardial Perfusion Imaging - methods
Predictive value of tests
Preoperative Care
Prospective Studies
Radiopharmaceuticals - diagnostic use
Recovery of Function
Stroke Volume
Technetium Tc 99m Sestamibi - diagnostic use
Time Factors
Treatment Outcome
Vascular Patency
Ventricular Function, Left
Abstract
OBJECTIVES We wanted to evaluate whether preoperative myocardial perfusion scintigraphy (MPS) could predict changes in cardiac symptoms and postoperative myocardial perfusion and left ventricular function after coronary artery bypass grafting (CABG). METHODS Ninety-two patients with stable angina pectoris (and at least one occluded coronary artery) underwent MPS before, and 6 months after, undergoing CABG. The result of the MPS was kept secret from the surgeons. RESULTS Before CABG, 90% of the patients had angina. After CABG, 97% of the patients were without symptoms. Overall graft patency was 84%. Before CABG, one patient had normal perfusion; in the rest of them the defects were classified as follows: reversible (60%), partly reversible (27%) and irreversible (12%). Following CABG, 33% had normal perfusion; in the rest the defects were reversible in 29%, partly reversible in 12% and irreversible in 26%. Left ventricular ejection fraction (LVEF), which was normal before operation in 45%, improved in 40% of all patients. The increase in LVEF was not related to the preoperative pattern of perfusion defects. Of 30 patients with normalized perfusion after CABG, 29 (97%) had reversible defects and one patient had partly reversible defects. Of 83 perfusion defects, which were normalized after CABG, 67 were reversible (81%) or partly reversible (12%). Seventy-five percent of all reversible coronary artery territories before CABG were normalized after operation. CONCLUSIONS Our results indicate that reversible or partly reversible perfusion defects at a preoperative MPS have a high chance of normalized myocardial perfusion assessed by MPS 6 months after operation. Normal perfusion is obtained almost exclusively in territories with reversible ischaemia. Symptoms improved in nearly all patients and LVEF in a significant fraction of the patients, not related to preoperative MPS.
Notes
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PubMed ID
22473665 View in PubMed
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Captopril renography as a prognostic factor in obstructive hydronephrosis with preserved renal function.

https://arctichealth.org/en/permalink/ahliterature98615
Source
Rev Esp Med Nucl. 2010 Jan-Feb;29(1):20-4
Publication Type
Article
Author
S. Ajmi
K. Ben Ali
M. Guezguez
R. Sfar
M. Nouira
Author Affiliation
Department of Nuclear Medicine, Sahloul's Hospital, Sousse, Tunisia. ajmi_sami@hotmail.com
Source
Rev Esp Med Nucl. 2010 Jan-Feb;29(1):20-4
Language
English
Publication Type
Article
Keywords
Angiotensin II - physiology
Angiotensin-Converting Enzyme Inhibitors - diagnostic use - pharmacology
Captopril - diagnostic use - pharmacology
Child
Humans
Hydronephrosis - physiopathology - radionuclide imaging - surgery
Kidney - drug effects - physiopathology
Kidney Function Tests - methods
Kidney Tubules, Collecting - radionuclide imaging
Male
Peristalsis - drug effects
Prognosis
Radiopharmaceuticals - diagnostic use
Technetium Tc 99m Pentetate - diagnostic use
Abstract
Hydronephrotic kidney with a differential renal function greater than 55% is defined as supranormal. The signification of this finding remains controversial. In this article, the authors reported a case of supranormal function in obstructive hydronephrosis. Differential renal functions were evaluated after administration of captopril and after pyeloplasty. The role of captopril renography as a prognostic factor for surgery is discussed.
PubMed ID
20005018 View in PubMed
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Cardiac ??mTc sestamibi SPECT and ยน8F FDG PET as viability markers in Takotsubo cardiomyopathy.

https://arctichealth.org/en/permalink/ahliterature263237
Source
Int J Cardiovasc Imaging. 2014 Oct;30(7):1407-16
Publication Type
Article
Date
Oct-2014
Author
Thomas Emil Christensen
Lia Evi Bang
Lene Holmvang
Adam Ali Ghotbi
Martin Lyngby Lassen
Flemming Andersen
Nikolaj Ihlemann
Hedvig Andersson
Peer Grande
Andreas Kjaer
Philip Hasbak
Source
Int J Cardiovasc Imaging. 2014 Oct;30(7):1407-16
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Aged
Coronary Angiography
Denmark
Female
Fluorodeoxyglucose F18 - diagnostic use
Heart Ventricles - physiopathology - radionuclide imaging - ultrasonography
Humans
Male
Myocardial Contraction
Positron-Emission Tomography
Predictive value of tests
Prognosis
Radiopharmaceuticals - diagnostic use
Recovery of Function
Takotsubo Cardiomyopathy - physiopathology - radiography - radionuclide imaging - ultrasonography
Technetium Tc 99m Sestamibi - diagnostic use
Time Factors
Tissue Survival
Tomography, Emission-Computed, Single-Photon
Ventricular Function, Left
Abstract
In patients with heart failure (HF) due to coronary disease, a combined evaluation of perfusion and glucose metabolism by cardiac single photon emission computed tomography (SPECT)/positron emission tomography (PET) can be used to distinguish viable from non-viable myocardium, and current guidelines recommend cardiac SPECT and fluorodeoxyglucose (FDG) PET for viability assessment. Takotsubo cardiomyopathy (TTC) is a disease characterized by acute but reversible HF leaving no scarring. To explore how robust the semi-quantitative viability criteria used in cardiac SPECT and FDG PET stands their ground in a population with TTC. From 1 September 2009 to 1 October 2012, 24 patients suspected of TTC were enrolled in a multimodality cardiac imaging research project. Echocardiography, (99m)Tc SPECT, and (18)F FDG PET were performed during the acute admission and at follow-up 4 months later. Nineteen patients had a final diagnosis of TTC consistent with Mayo Clinic Diagnostic Criteria. Three of these patients were excluded from further analysis, since wall motion abnormalities were not persistent at the time of nuclear imaging. The remaining sixteen patients exhibited a distinct pattern with HF, "apical ballooning" and a perfusion-metabolism defect in the midventricular/apical region. When viability criteria were applied, they identified significant scarring/limited hibernation in the akinetic part of the left ventricle. However, full recovery was found in all TTC patients on follow-up. Using the current guideline-endorsed viability criteria for semiquantitative cardiac SPECT and FDG PET, these modalities failed to demonstrate the presence of viability in the acute state of TTC.
PubMed ID
24852336 View in PubMed
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Clinical interpretation standards and quality assurance for the multicenter PET/CT trial rubidium-ARMI.

https://arctichealth.org/en/permalink/ahliterature106077
Source
J Nucl Med. 2014 Jan;55(1):58-64
Publication Type
Article
Date
Jan-2014
Author
Jennifer M Renaud
Ilias Mylonas
Brian McArdle
Taylor Dowsley
Kathy Yip
Eric Turcotte
Jean Guimond
Mikael Trottier
Philipe Pibarot
Conor Maguire
Lucille Lalonde
Karen Gulenchyn
Gerald Wisenberg
R Glenn Wells
Terrence Ruddy
Benjamin Chow
Rob S B Beanlands
Robert A deKemp
Author Affiliation
University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Source
J Nucl Med. 2014 Jan;55(1):58-64
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Aged
Canada
Cost-Benefit Analysis
Female
Heart - radionuclide imaging
Humans
Imaging, Three-Dimensional
Male
Middle Aged
Multimodal Imaging - methods - standards
Observer Variation
Phantoms, Imaging
Positron-Emission Tomography - methods
Quality Assurance, Health Care
Radiopharmaceuticals - diagnostic use
Reproducibility of Results
Rubidium Radioisotopes - diagnostic use
Tomography, Emission-Computed, Single-Photon - methods
Tomography, X-Ray Computed - methods
Translational Medical Research
Treatment Outcome
Abstract
Rubidium-ARMI ((82)Rb as an Alternative Radiopharmaceutical for Myocardial Imaging) is a multicenter trial to evaluate the accuracy, outcomes, and cost-effectiveness of low-dose (82)Rb perfusion imaging using 3-dimensional (3D) PET/CT technology. Standardized imaging protocols are essential to ensure consistent interpretation.
Cardiac phantom qualifying scans were obtained at 7 recruiting centers. Low-dose (10 MBq/kg) rest and pharmacologic stress (82)Rb PET scans were obtained in 25 patients at each site. Summed stress scores, summed rest scores, and summed difference scores (SSS, SRS, and SDS [respectively] = SSS-SRS) were evaluated using 17-segment visual interpretation with a discretized color map. All scans were coread at the core lab (University of Ottawa Heart Institute) to assess agreement of scoring, clinical diagnosis, and image quality. Scoring differences greater than 3 underwent a third review to improve consensus. Scoring agreement was evaluated with intraclass correlation coefficient (ICC-r), concordance of clinical interpretation, and image quality using ? coefficient and percentage agreement. Patient (99m)Tc and (201)Tl SPECT scans (n = 25) from 2 centers were analyzed similarly for comparison to (82)Rb.
Qualifying scores of SSS = 2, SDS = 2, were achieved uniformly at all imaging sites on 9 different 3D PET/CT scanners. Patient scores showed good agreement between core and recruiting sites: ICC-r = 0.92, 0.77 for SSS, SDS. Eighty-five and eighty-seven percent of SSS and SDS scores, respectively, had site-core differences of 3 or less. After consensus review, scoring agreement improved to ICC-r = 0.97, 0.96 for SSS, SDS (P
PubMed ID
24249797 View in PubMed
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75 records – page 1 of 8.