JNM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Krijnen, P.
Right arrow Articles by Habbema, J. D. F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Krijnen, P.
Right arrow Articles by Habbema, J. D. F.
Journal of Nuclear Medicine Vol. 43 No. 3 330-337
© 2002 by Society of Nuclear Medicine

Clinical Investigations

Interobserver Agreement on Captopril Renography for Assessing Renal Vascular Disease

Pieta Krijnen, MSc1, Hong-Yoe Oei, MD, PhD2, Roel A.M.J. Claessens, MD, PhD3, Jan C. Roos, MD, PhD4, Brigit C. van Jaarsveld, MD, PhD5 and J. Dik F. Habbema, PhD1

1 Center for Clinical Decision Sciences, Department of Public Health, Erasmus University Rotterdam, Rotterdam, The Netherlands
2 Department of Nuclear Medicine, University Hospital Rotterdam-Dijkzigt, Rotterdam, The Netherlands
3 Department of Nuclear Medicine, Bosch Medicentrum, ‘s Hertogenbosch, The Netherlands
4 Department of Nuclear Medicine, University Hospital Vrije Universiteit, Amsterdam, The Netherlands
5 Dianet Dialysis Centers, Utrecht, The Netherlands

Captopril-stimulated renography is widely used to screen selected groups of hypertensive patients for renal vascular disease. Evaluation of the test is a complex task. Lack of interobserver agreement on the assessment and interpretation of renographic parameters may contribute to differences in sensitivity and specificity between studies. Methods: Three experienced nuclear medicine physicians evaluated 658 renograms of 503 hypertensive patients suspected of having renal vascular disease from a large Dutch multicenter study (the Dutch Renal Artery Stenosis Intervention Cooperative [DRASTIC] study). Interobserver agreement on several renographic parameters was assessed by the {kappa} statistic and the intraclass correlation coefficient (ICC). Results: The interobserver agreement on the time to excretion was high: The pooled ICC was 0.90. The pooled {kappa} was >=0.65 for the pattern of the time–activity curves, the visual aspect of the scintigraphic images (visible uptake and kidney size), and the judgment on the presence of renal artery stenosis. However, the interobserver agreement on cortical retention and pelvic retention by visual inspection of the images was rather low (pooled {kappa} = 0.46 and 0.52, respectively). Pelvic retention was found to complicate the interpretation of renography. Conclusion: Interobserver agreement on most of the renographic parameters was satisfactory, but the assessment of cortical retention was more difficult, in particular, in the presence of pelvic retention. Captopril renography should be interpreted with caution if pelvic retention is suspected. Interobserver variability offers one of several explanations for the differences in diagnostic test performance that are found between studies.

Key Words: renography • interobserver agreement • renovascular hypertension






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY THE JOURNAL OF NUCLEAR MEDICINE
Copyright © 2002 by the Society of Nuclear Medicine.