TY - JOUR T1 - Visual interpretation of 18F-Florbetapir PET-CT images in patients with cognitive impairment of a multicenter clinical research project - INDIA-FBP study: are the different visual criteria of amyloid images assessment similar in clinical practice and could their incorporation reduce the inter-reader variability? JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 554 LP - 554 VL - 58 IS - supplement 1 AU - Barbara PAGHERA AU - ALESSIA PELI AU - UGOPAOLO GUERRA AU - Daniele ALTOMARE AU - RAFFAELE GIUBBINI Y1 - 2017/05/01 UR - http://jnm.snmjournals.org/content/58/supplement_1/554.abstract N2 - 554Objectives: to determine the intra-reader and inter-rater variability of the visual interpratation of 18F-Florbetapir PET/CT regarding the positivity/negativity for amyloid deposition, using 3 different visual criteria recommended by the 3 companies producing 18F- compounds for β-amyloid plaques detection (Eli-Lilly AMYVID with 18F-Florbetapir; GE -VIZAMYL with18F-Flutemetamol and Piramal -NEURACEQ with 18F-Florbetaben) by readers with different experience. We hypothesized that incorporating different visual criteria for amyloid imaging assessment into 18F-Florbetapir PET/CT brain scan interpretation would reduce the inter-reader variability.Methods: : we analyzed a total of 252 18F-Florbetapir PET/CT studies (228 patients with cognitive impairment and 24 normal cognitive control), obtained in subjects participating in a multicenter clinical research project (INDIA-FBP study) and performed in 2 centers. Six indipendent blinded readers (02 experts and 04 without direct clinical experience) examined each PET study three times according to three different visual criteria, classifing them with a confidence level of 5 point score (4:definitely positive; 3:doubt positive; 2: true doubt; 1: doubt negative or 0: definitely negative). After the first reading, discordant cases were reevaluated by the 02 experts readers reaching a final agreement incorporating all visual criteria.Results: substantial to almost perfect agreement was observed for visual interpretation by the six readers' confidence level (mean weighted Kappa): mwK = 0,82 for AMYVID lecture; mwK = 0,84 for PIRAMAL lecture; mwK = 0,85 for GE lecture. The 5 point score showed a low inter-readers variability: mwK = 0,73 for AVID lecture; mwK = 0,82 for PIRAMAL lecture and mean Spearman's rho = 0,82 for GE. The intra-rater agreement on images scoring was almost perfect with Spearman's rho ranging 0,89 - 1,00 (p < 0,001); the intra-rater agreement showed Spearman's rho ranging 0,75 - 0,90 (p < 0,001). In 26/252 cases (10%) was observed a disagreement between the 02 experts readers and after the second indipendent reading, incorporating all the criteria, reached an agreement in 17/26 cases (65%). The residual disagreement between the two experts readers was 09/252 cases (3%).Conclusion: there is an high inter-rater and intra-reader agreement using the three different visual criteria for amyloid images. We have found that all the criteria proposed are useful to determine the positivity or negativity of amyloid deposition and that the incorporation of them provides a better agreement between expert readers. Research Support: for this study the authors didn't receive any support ER -