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Quality of planar whole-body bone scan interpretations - a nationwide survey

Sadik, May; Suurkula, Madis; Höglund, Peter LU ; Jarund, Andreas and Edenbrandt, Lars LU (2008) In European Journal of Nuclear Medicine and Molecular Imaging 35(8). p.1464-1472
Abstract
Purpose The purpose of this study was to investigate, in a nationwide study, the inter-observer variation and performance in interpretations of bone scans regarding the presence or absence of bone metastases. Methods Bone scan images from 59 patients with breast or prostate cancer, who had undergone scintigraphy due to suspected bone metastatic disease, were studied. The patients were selected to reflect the spectrum of pathology found in everyday clinical work. Whole body images, anterior and posterior views, were sent to all 30 hospitals in Sweden that perform bone scans. Thirty-seven observers from 18 hospitals agreed to participate in the study. They were asked to classify each of the patient studies regarding the presence of bone... (More)
Purpose The purpose of this study was to investigate, in a nationwide study, the inter-observer variation and performance in interpretations of bone scans regarding the presence or absence of bone metastases. Methods Bone scan images from 59 patients with breast or prostate cancer, who had undergone scintigraphy due to suspected bone metastatic disease, were studied. The patients were selected to reflect the spectrum of pathology found in everyday clinical work. Whole body images, anterior and posterior views, were sent to all 30 hospitals in Sweden that perform bone scans. Thirty-seven observers from 18 hospitals agreed to participate in the study. They were asked to classify each of the patient studies regarding the presence of bone metastasis, using a four-point scale. Each observer's classifications were pairwise compared with the classifications made by all the other observers, resulting in 666 pairs of comparisons. The interpretations of the 37 observers were also compared with the final clinical assessment, which was based on follow-up scans and other clinical data. Results On average, two observers agreed on 64% of the bone scan classifications. Kappa values ranged between 0.16 and 0.82, with a mean of 0.48. Sensitivity and specificity for the observers compared with the final clinical assessment were 77% and 96%, respectively, for detecting bone metastases in planar whole-body bone scanning. Conclusions Moderate inter-observer agreement was found when observers were compared pairwise. False-negative errors seem to be the major problem in the interpretations of bone scan images, whilst the specificities for the observers were high. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
breast, bone metastases, inter-observer variation, radionuclide imaging, cancer, prostate cancer
in
European Journal of Nuclear Medicine and Molecular Imaging
volume
35
issue
8
pages
1464 - 1472
publisher
Springer
external identifiers
  • wos:000257922400008
  • scopus:48149106769
ISSN
1619-7070
DOI
10.1007/s00259-008-0721-5
language
English
LU publication?
yes
id
debdce87-b8fe-46da-b3dc-30527e18d32d (old id 1253720)
date added to LUP
2008-11-10 11:26:51
date last changed
2017-09-17 05:16:52
@article{debdce87-b8fe-46da-b3dc-30527e18d32d,
  abstract     = {Purpose The purpose of this study was to investigate, in a nationwide study, the inter-observer variation and performance in interpretations of bone scans regarding the presence or absence of bone metastases. Methods Bone scan images from 59 patients with breast or prostate cancer, who had undergone scintigraphy due to suspected bone metastatic disease, were studied. The patients were selected to reflect the spectrum of pathology found in everyday clinical work. Whole body images, anterior and posterior views, were sent to all 30 hospitals in Sweden that perform bone scans. Thirty-seven observers from 18 hospitals agreed to participate in the study. They were asked to classify each of the patient studies regarding the presence of bone metastasis, using a four-point scale. Each observer's classifications were pairwise compared with the classifications made by all the other observers, resulting in 666 pairs of comparisons. The interpretations of the 37 observers were also compared with the final clinical assessment, which was based on follow-up scans and other clinical data. Results On average, two observers agreed on 64% of the bone scan classifications. Kappa values ranged between 0.16 and 0.82, with a mean of 0.48. Sensitivity and specificity for the observers compared with the final clinical assessment were 77% and 96%, respectively, for detecting bone metastases in planar whole-body bone scanning. Conclusions Moderate inter-observer agreement was found when observers were compared pairwise. False-negative errors seem to be the major problem in the interpretations of bone scan images, whilst the specificities for the observers were high.},
  author       = {Sadik, May and Suurkula, Madis and Höglund, Peter and Jarund, Andreas and Edenbrandt, Lars},
  issn         = {1619-7070},
  keyword      = {breast,bone metastases,inter-observer variation,radionuclide imaging,cancer,prostate cancer},
  language     = {eng},
  number       = {8},
  pages        = {1464--1472},
  publisher    = {Springer},
  series       = {European Journal of Nuclear Medicine and Molecular Imaging},
  title        = {Quality of planar whole-body bone scan interpretations - a nationwide survey},
  url          = {http://dx.doi.org/10.1007/s00259-008-0721-5},
  volume       = {35},
  year         = {2008},
}