• Title/Summary/Keyword: Concordance Correlation Coefficient

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Comparative Volume Measuring Methods According to the Tumor Characters in PET/CT (PET/CT 검사에서 종양의 특성에 따른 체적 측정 방법 비교)

  • Choi, Yong Hoon;Ban, Yung Gak;Oh, Shin Hyun;Lim, Han Sang;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.52-58
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    • 2016
  • Purpose Recent retrospective studies are being actively conducted to analyze the survival of patients with SUVmax, MTV, TLG, such as information from a variety of PET originating. However, there is no clear way is difficult to accurately measure the volume of the tumor may be the difference between the caster is raised. In this study, to evaluate compare the volume measuring methods according to the characteristics of the tumor. Materials and Methods 18F-saline to fill the NEMA IEC Body Phantom insert the volume of balance and imbalance in phantom were acquired to the Biograph truepoint 40 (Siemens medical system, Germany) PET/CT scanner. The ratio of the volume and Background was acquired as 3.0, 5.0, 8.0, 18, 40. Clinical patients were randomly selected 120 people in staging patients with cancer of the digestive system from the year 2010 until the year 2014. Measurement methods were used a 40% threshold, 50% threshold and gradient segmentation technique, i.e. PET EDGE. Five years of experience of the two radio-technologist and one doctor was measured by repeated three times. Analysis methods were Intraclass correlation coefficient and Pearson correlation. Results In Phantoms, the 40% threshold method gave the best concordance between measured and actual volumes (r = 0.992, 0.997). In clinical patient outcome agreement between observers EDGE it is as high as 0.999 (CI: 0.998-0.999). And there were no statistical significance of the difference between the measurements (P = 0.620). 40% threshold method showed the best correlation between the measurements (r = 0.953). Increasing the ratio of tumor to background decreased the influence of a measuring method. Conclusion How to measure volume of the tumor in the patient was clinically most useful is 50% and the lowest impact on the characteristics of the tumor. Therefore, to reduce the background of the patients in PET/CT scan, it should be required research and effort.

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Inter-fractional Target Displacement in the Prostate Image-Guided Radiotherapy using Cone Beam Computed Tomography (전립선암 영상유도 방사선 치료시 골반내장기의 체적변화에 따른 표적장기의 변화)

  • Dong, Kap Sang;Back, Chang Wook;Jeong, Yun Jeong;Bae, Jae Beom;Choi, Young Eun;Sung, Ki Hoon
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.161-169
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    • 2016
  • Purpose : To quantify the inter-fractional variation in prostate displacement and their dosimetric effects for prostate cancer treatment. Materials and Methods : A total of 176 daily cone-beam CT (CBCT) sets acquired for 6 prostate cancer patients treated with volumetric-modulated arc therapy (VMAT) were retrospectively reviewed. For each patient, the planning CT (pCT) was registered to each daily CBCT by aligning the bony anatomy. The prostate, rectum, and bladder were delineated on daily CBCT, and the contours of these organs in the pCT were copied to the daily CBCT. The concordance of prostate displacement, deformation, and size variation between pCT and daily CBCT was evaluated using the Dice similarity coefficient (DSC). Results : The mean volume of prostate was 37.2 cm3 in the initial pCT, and the variation was around ${\pm}5%$ during the entire course of treatment for all patients. The mean DSC was 89.9%, ranging from 70% to 100% for prostate displacement. Although the volume change of bladder and rectum per treatment fraction did not show any correlation with the value of DSC (r=-0.084, p=0.268 and r=-0.162, p=0.032, respectively), a decrease in the DSC value was observed with increasing volume change of the bladder and rectum (r=-0.230,p=0.049 and r=-0.240,p=0.020, respectively). Conclusion : Consistency of the volume of the bladder and rectum cannot guarantee the accuracy of the treatment. Our results suggest that patient setup with the registration between the pCT and daily CBCT should be considered aligning soft tissue.

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Interobserver Reproducibility of Segmental Scoring of $^{99m}Tc$-MIBI Myocardial SPECT ($^{99m}Tc$-MIBI 심근 SPECT의 분절 육안 분석시 판독자간의 일치도)

  • Yeo, Jeong-Seok;Lee, Dong-Soo;Lee, Kyung-Han;Kim, Jong-Ho;Shon, Kyung-Soo;Cho, Sung-Wook;Kwark, Cheol-Eun;Chung, June-Key;Lee, Myung-Chul;Seo, Jeong-Don;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.317-325
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    • 1994
  • The accuracy of dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial imaging for detection of ischemia depends on reproducible image interpretation. To evaluate the reproducibility of visual assessment, agreement in interpretation among two independent observers, blind-ed to clinical data, was evaluated in SPECT images of 131 patients (94 males, 38 females; mean age $58{\pm}7yr$) with suspected coronary artery disease who underwent both dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial SPECT and coronary angiography. The left ventricle was divided into twenty-nine segments in stress and rest SPECT images and each segment was visually graded according to a five-point scale (segmental score : 0=normal, 1=equivocal, 2=mild decrease, 3=severe decrease and 4=absent uptake). Overall concordance of segmental scoring between the two observers was 80%. The Pear-son's correlation coefficient (r) of the segmental scores for stress and rest images were 0.67 and 0.65, respectively, while the difference in score between the two images showed a correlation of 0.45 (all p<0.001). Agreement between two observers in final SPECT diagnosis as absence or presence of disease was 93%. The degree of agreement in segmental scoring showed no difference between patients with or without agreement as to the presence of disease. Therefore it appeared that cases with inconcordant diagnosis between the 2 observers were mainly due to a difference in individual threshold for interpretating the significance of a particular decreased uptake area rather than to a difference in perceiving the degree of the hypoactivity Thus, establishment of individual optimum thresholds in visual interpretation of myocardial SPECT may be helpful to improve reproducibility and accuracy of scan diagnosis.

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