Lidija Antunovic, Alessia Artesani, Michael Coniglio, Wim J G Oyen, Michele Ciccarelli, Carlo Selmi, Arturo Chiti, Martina Sollini
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引用次数: 0
Abstract
Background: Diagnosis of vasculitis is challenging. To avoid invasive approaches, clinical guidelines recommend the use of diagnostic imaging. This study aimed at evaluating the diagnostic accuracy of [18F]-fluorodeoxyglucose ([18F]FDG) position emission tomography/computed tomography (PET/CT) in large vessel vasculitis (LVV) and how this is affected by inter-operator variability.
Methods: A total of 279 patients who performed [18F]-FDG PET/CT for suspicion of LVV were retrospectively analyzed. We tested the qualitative and semi-quantitative analysis and parameters influencing image quality and interpretation. Exams were evaluated by two readers with different experience and their performance was compared.
Results: LVV diagnosis was confirmed in 81 patients. [18F]-FDG PET/CT accuracy was 73% and 67% for the expert reader and less experienced reader, respectively. The expert reader overall performed better than the less experienced one, with higher accuracy in patients with normal BMI (77.3 vs. 63.8%), normal level of glycemia (73.3 vs. 65%), younger age (76.6 vs. 68.2%), and when no therapy was in course at time of imaging (76.7 vs. 66.7%). The diagnostic performance of both readers did not improve using semi-quantitative parameters.
Conclusions: We confirmed the appropriateness of the recommended criteria for image acquisition and interpretation, underlining the importance of experience in image interpretation for the optimal diagnostic performance of [18F]FDG PET/CT in vasculitis.
背景:血管炎的诊断具有挑战性。为了避免侵入性入路，临床指南建议使用诊断性影像学。本研究旨在评估[18F]-氟脱氧葡萄糖([18F]FDG)位置发射断层扫描/计算机断层扫描(PET/CT)对大血管炎(LVV)的诊断准确性，以及操作员间差异对其的影响。方法:回顾性分析279例经[18F]-FDG PET/CT检查怀疑LVV的患者。我们测试了定性和半定量分析以及影响图像质量和解释的参数。由两名具有不同经验的阅卷人对试题进行评价，并比较其表现。结果:81例患者确诊LVV。[18F]-FDG PET/CT在专业阅读者和经验不足阅读者中的准确率分别为73%和67%。专家阅读者的总体表现优于经验不足的阅读者，在BMI正常(77.3 vs. 63.8%)、血糖水平正常(73.3 vs. 65%)、年龄较小(76.6 vs. 68.2%)和成像时未进行治疗的患者中准确率更高(76.7 vs. 66.7%)。使用半定量参数时，两种读卡器的诊断性能均未得到改善。结论:我们确认了推荐的图像采集和解释标准的适用性，强调了图像解释经验对血管炎FDG PET/CT的最佳诊断性能的重要性[18F]。
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