| Japanese |
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| Title | 201Tl SPECT・MRIによる脳疾患診断の医師間変動の評価 |
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| Subtitle | 《原著》 |
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| Authors | 町田喜久雄*1, 本田憲業*1, 松本徹*2, 油井信春*3, 戸川貴史*3, 久保敦司*4, 塚谷泰司*4, 小山田日吉丸*4, 石井勝己*5, 西巻博*5, 森豊*6, 宇野公一*7, 村田啓*8, 丸野広大*8 |
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| Authors(kana) | |
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| Organization | *1埼玉医科大学総合医療センター, *2放射線医学総合研究所, *3千葉県がんセンター, *4慶應義塾大学医学部放射線科, *5北里大学医学部放射線科, *6東京慈恵会医科大学放射線科, *7千葉大学医学部, *8虎の門病院核医学科 |
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| Journal | 核医学 |
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| Volume | 33 |
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| Number | 9 |
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| Page | 943-952 |
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| Year/Month | 1996/9 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」54例の脳腫瘍患者のTl SPECT像を9人の医師が読影する実験を2回に分けて行った. 医師は, 第1回目はMRIを参照せず, 第2回目はMRIを参照して, 201Tlの異常集積の存在診断と部位の同定および良性・悪性鑑別を行った. これよりMRI参照の有無時における診断結果の医師間変動を比較した. Tl-SPECTの異常所見の検出率はMRIを参照しない時医師全体で84%, 参照時94%となり, 医師間変動はMRIを参照することで有意に減少した. 良性と悪性の鑑別能を表す医師全体のROC曲線の第1動作点はMRIを参照しない時TPR: 53%, FPR: 28%であり, MRI参照時TPR: 74%, FPR: 45%となったが, ROC曲線下面積Azおよびその医師間変動はMRI参照の有無と関係を生じなかった. 201Tl異常所見部位の同定では, 前頭葉と側頭葉および脳幹の判断基準について医師間で合意を図る必要性が示唆された. |
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| Practice | 臨床医学：一般 |
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| Keywords | 201Tl SPECT, MRI, Diagnostic efficacy, Interobserver variation, ROC analysis. |
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| English |
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| Title | Diagnostic Accuracy of 201Tl SPECT・MRI in Brain Diseases and Inter-reader Variance of Diagnostic Performance |
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| Subtitle | - Original Articles - |
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| Authors | Kikuo MACHIDA*1, Norinari HONDA*1, Toru MATSUMOTO*2, Nobuharu YUI*3, Takashi TOGAWA*3, Atsushi KUBO*4, Yasushi TSUKATANI*4, Hiyoshimaru OYAMADA*4, Katsumi ISHII*5, Hiroshi NISHIMAKI*5, Yutaka MORI*6, Kimiichi UNO*7, Hajime MURATA*8, Hirotaka MARUNO*8 |
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| Authors(kana) | |
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| Organization | *1Saitama Medical Center, Saitama Medical School, *2National Institute of Radiological Sciences, *3Chiba Cancer Center Hospital, *4School of Medicine, Keio University, *5School of Medicine, Kitazato University, *6Jikei University School of Medicine, *7School of Medicine, Chiba University, *8Toranomon Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 33 |
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| Number | 9 |
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| Page | 943-952 |
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| Year/Month | 1996/9 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | Fifteen-four studies of 201Tl brain tumor SPECT were independently interpreted by 9 nuclear medicine physicians with and without reference magnetic resonance images in 2 separate sessions to define an effect of referring images, and inter-observer variations. The physicians were requested to detect foci of abnormal deposits, and to discriminate whether they were malignant or not according to 5-grade scaling of subjective diagnostic confidence. Receiver-operating characteristics (ROC) analysis was performed. Mean sensitivity for presence of lesions (SFP), and sensitivity and specificity for malignancy of 201Tl SPECT were 84, and 53 and 55%, which were changed to 94, and 74 and 55% after referring to the MR images. The SFP was significantly improved (p<0.05), but sensitivity and specificity for malignancy, assessed by areas under the ROC curves, were not significantly improved. Inter-observer variation of the SFP was significantly reduced with addition of the referring MR images. Cerebral lobar localization of lesions by SPECT showed great inter-observer variations (true localization ranged from 30 to 68.4%). It is concluded that 201Tl brain tumor SPECT has moderate sensitivity and specificity for malignancy, which is not improved by addition of anatomical reference images, that additional MR images reduce inter-observer variation of confidence on lesion presence, and that SPECT localization of lesions has great inter-observer variations. |
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| Practice | Clinical medicine |
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| Keywords | 201Tl SPECT, MRI, Diagnostic efficacy, Interobserver variation, ROC analysis. |
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