RT Journal Article
SR Electronic
T1 Visual-Statistical Interpretation of <sup>18</sup>F-FDG-PET Images for Characteristic Alzheimer Patterns in a Multicenter Study: Inter-Rater Concordance and Relationship to Automated Quantitative Evaluation
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 244
OP 249
DO 10.3174/ajnr.A3665
VO 35
IS 2
A1 T. Yamane
A1 Y. Ikari
A1 T. Nishio
A1 K. Ishii
A1 K. Ishii
A1 T. Kato
A1 K. Ito
A1 D.H.S. Silverman
A1 M. Senda
A1 T. Asada
A1 H. Arai
A1 M. Sugishita
A1 T. Iwatsubo
A1 the J-ADNI Study Group
YR 2014
UL http://www.ajnr.org/content/35/2/244.abstract
AB BACKGROUND AND PURPOSE: The role of 18F-FDG-PET in the diagnosis of Alzheimer disease is increasing and should be validated. The aim of this study was to assess the inter-rater variability in the interpretation of 18F-FDG-PET images obtained in the Japanese Alzheimer's Disease Neuroimaging Initiative, a multicenter clinical research project. MATERIALS AND METHODS: This study analyzed 274 18F-FDG-PET scans (67 mild Alzheimer disease, 100 mild cognitive impairment, and 107 normal cognitive) as baseline scans for the Japanese Alzheimer's Disease Neuroimaging Initiative, which were acquired with various types of PET or PET/CT scanners in 23 facilities. Three independent raters interpreted all PET images by using a combined visual-statistical method. The images were classified into 7 (FDG-7) patterns by the criteria of Silverman et al and further into 2 (FDG-2) patterns. RESULTS: Agreement among the 7 visual-statistical categories by at least 2 of the 3 readers occurred in &gt;94% of cases for all groups: Alzheimer disease, mild cognitive impairment, and normal cognitive. Perfect matches by all 3 raters were observed for 62% of the cases by FDG-7 and 76 by FDG-2. Inter-rater concordance was moderate by FDG-7 (κ = 0.57) and substantial in FDG-2 (κ = 0.67) on average. The FDG-PET score, an automated quantitative index developed by Herholz et al, increased as the number of raters who voted for the AD pattern increased (ρ = 0.59, P &lt; .0001), and the FDG-PET score decreased as those for normal pattern increased (ρ = −0.64, P &lt; .0001). CONCLUSIONS: Inter-rater agreement was moderate to substantial for the combined visual-statistical interpretation of 18F-FDG-PET and was also significantly associated with automated quantitative assessment. ADAlzheimer diseaseJ-ADNIJapanese Alzheimer's Disease Neuroimaging InitiativeMCImild cognitive impairmentNCcognitively normal subject