Equilibrium radionuclide angiography: Intra- and inter-observer repeatability and reproducibility in the assessment of cardiac systolic and diastolic function

J Nucl Cardiol. 2021 Aug;28(4):1304-1314. doi: 10.1007/s12350-019-01830-9. Epub 2019 Aug 5.

Abstract

Background: This study aimed to assess intra- and inter-observer agreement in assessing the systolic and diastolic function with equilibrium radionuclide angiography (ERNA).

Materials and methods: Thirty-two adults underwent baseline and repeat ERNA. An experienced and a trainee operator analyzed the data by assigning regions of interest manually, fully automatically, and semi-automatically. The Bland-Altman statistic (mean ± 1.96 standard deviations of the differences) was used to assess the repeatability (two different assessments of a single acquisition) and reproducibility (assessments of two different acquisitions).

Results: Using the semi-automated technique the intraobserver repeatability and reproducibility of left ventricular ejection fraction for the experienced physician were - 0.1 ± 3.7 and 0.0 ± 3.8 and for the trainee 2.2 ± 10.6 and 1.9 ± 8.4, respectively. The inter-observer repeatability and reproducibility were - 1.8 ± 6.4 and 0.4 ± 9.0, respectively. Among the parameters of diastolic function, the intraobserver repeatability and reproducibility of the peak filling rate for the experienced physician were - 0.0 ± 1.1 and - 0.1 ± 1.1 and for the trainee 0.2 ± 3.5 and 0.4 ± 3.7, respectively. The inter-observer repeatability and reproducibility were 0.3 ± 1.5 and 0.5 ± 4.0, respectively. Similar was the pattern for the other diastolic indices. In all cases the limits of agreement varied according to the quantification approach.

Conclusion: A good repeatability but a moderate reproducibility was found in the assessment of the LVEF. Less good were the findings in the assessment of diastolic function.

Keywords: ERNA: planar; interobserver; intraobserver; repeatability; reproducibility.

MeSH terms

  • Adult
  • Aged
  • Coronary Angiography*
  • Diastole / physiology*
  • Female
  • Gated Blood-Pool Imaging*
  • Heart Diseases / diagnostic imaging
  • Heart Diseases / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Radionuclide Angiography*
  • Reproducibility of Results
  • Stroke Volume / physiology
  • Systole / physiology*