Key result
BMIPP SPECT interpretations show only fair agreement between expert and clinical readers, diminishing prognostic value.
Why the study?
Interpretive variability and its impact on the prognostic value of myocardial fatty acid imaging in asymptomatic hemodialysis patients were unknown.
Does the skill level of the reader (expert vs clinical center) affect the interpretative agreement and prognostic value of BMIPP SPECT imaging in asymptomatic hemodialysis patients?
Population
677 asymptomatic hemodialysis patients with ≥ 20 years treatment and cardiovascular risk factors in Japan
Comparison
Interpretation of BMIPP SPECT images by nuclear core laboratory experts vs clinical center readers with varying skill levels
Design
Multicenter cohort study with independent image interpretation
Authors
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Interpretive variability in BMIPP SPECT may undermine prognostic discrimination in hemodialysis; leaves open need for standardized protocols or training.
Cohort (n=677)
Yes
Does the skill level of the reader (expert vs clinical center) affect the interpretative agreement and prognostic value of BMIPP SPECT imaging in asymptomatic hemodialysis patients?
Effect estimate: κ=0.298
Absolute Event Rate: 60.9% vs 69.9%
Considerable interpretative variability exists in BMIPP SPECT imaging between experts and local readers, which significantly compromises its prognostic value in hemodialysis patients.
Kiriyama et al. (2014) conducted a cohort in Asymptomatic hemodialysis patients with cardiovascular risk factors (n=677). BMIPP SPECT image interpretation by clinical center readers vs. Interpretation by core laboratory experts was evaluated on Agreement for overall impression (normal vs. abnormal) (κ=0.298). Visual interpretation of BMIPP SPECT images between experts and clinical center readers showed only fair agreement (κ=0.298), which diminished the prognostic value of the scans.
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