TY - JOUR
T1 - High interobserver agreement for the standardized reporting system SSTR-RADS 1.0 on somatostatin receptor PET/CT
AU - Werner, Rudolf A.
AU - Derlin, Thorsten
AU - Rowe, Steven P.
AU - Bundschuh, Lena
AU - Sheikh, Gabriel T.
AU - Pomper, Martin G.
AU - Schulz, Sebastian
AU - Higuchi, Takahiro
AU - Buck, Andreas K.
AU - Bengel, Frank Michael
AU - Bundschuh, Ralph A.
AU - Lapa, Constantin
N1 - Funding Information:
This work was funded by the German Research Foundation (DFG), through the PRACTIS – Clinician Scientist Program of Hannover Medical School (ME 3696/3-1, RAW). No other potential conflict of interest relevant to this article was reported.
Publisher Copyright:
© 2021 Society of Nuclear Medicine Inc.. All rights reserved.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Recently, a standardized framework system for interpreting somatostatin receptor (SSTR)-targeted PET/CT, termed the SSTR reporting and data system (RADS) 1.0, was introduced, providing reliable standards and criteria for SSTR-targeted imaging. We determined the interobserver reliability of SSTR-RADS for interpretation of 68Ga-DOTATOC PET/CT scans in a multicentric, randomized setting. Methods: A set of 51 randomized 68Ga-DOTATOC PET/CT scans was independently assessed by 4 masked readers with different levels of experience (2 experienced readers and 2 inexperienced readers) trained on the SSTR-RADS 1.0 criteria (based on a 5-point scale from 1 [definitively benign] to 5 [high certainty that neuroendocrine neoplasia is present]). For each scan, SSTR-RADS scores were assigned to a maximum of 5 target lesions (TLs). An overall scan impression based on SSTR-RADS was indicated, and interobserver agreement rates on a TL-based, on an organ-based, and on an overall SSTR-RADS score-based level were computed. The readers were also asked to decide whether peptide receptor radionuclide therapy (PRRT) should be considered on the basis of the assigned RADS scores. Results: Among the selected TLs, 153 were chosen by at least 2 readers (all 4 readers selected the same TLs in 58 of 153 [37.9%] instances). The interobserver agreement for SSTR-RADS scoring among identical TLs was good (intraclass correlation coefficient [ICC] $ 0.73 for 4, 3, and 2 identical TLs). For lymph node and liver lesions, excellent interobserver agreement rates were derived (ICC, 0.91 and 0.77, respectively). Moreover, the interobserver agreement for an overall scan impression based on SSTR-RADS was excellent (ICC, 0.88). The SSTR-RADS-based decision to use PRRT also demonstrated excellent agreement, with an ICC of 0.80. No significant differences between experienced and inexperienced readers for an overall scan impression and TL-based SSTR-RADS scoring were observed (P $ 0.18), thereby suggesting that SSTR-RADS seems to be readily applicable even for less experienced readers. Conclusion: SSTR-RADS-guided assessment demonstrated a high concordance rate, even among readers with different levels of experience, supporting the adoption of SSTRRADS for trials, clinical routine, or outcome studies.
AB - Recently, a standardized framework system for interpreting somatostatin receptor (SSTR)-targeted PET/CT, termed the SSTR reporting and data system (RADS) 1.0, was introduced, providing reliable standards and criteria for SSTR-targeted imaging. We determined the interobserver reliability of SSTR-RADS for interpretation of 68Ga-DOTATOC PET/CT scans in a multicentric, randomized setting. Methods: A set of 51 randomized 68Ga-DOTATOC PET/CT scans was independently assessed by 4 masked readers with different levels of experience (2 experienced readers and 2 inexperienced readers) trained on the SSTR-RADS 1.0 criteria (based on a 5-point scale from 1 [definitively benign] to 5 [high certainty that neuroendocrine neoplasia is present]). For each scan, SSTR-RADS scores were assigned to a maximum of 5 target lesions (TLs). An overall scan impression based on SSTR-RADS was indicated, and interobserver agreement rates on a TL-based, on an organ-based, and on an overall SSTR-RADS score-based level were computed. The readers were also asked to decide whether peptide receptor radionuclide therapy (PRRT) should be considered on the basis of the assigned RADS scores. Results: Among the selected TLs, 153 were chosen by at least 2 readers (all 4 readers selected the same TLs in 58 of 153 [37.9%] instances). The interobserver agreement for SSTR-RADS scoring among identical TLs was good (intraclass correlation coefficient [ICC] $ 0.73 for 4, 3, and 2 identical TLs). For lymph node and liver lesions, excellent interobserver agreement rates were derived (ICC, 0.91 and 0.77, respectively). Moreover, the interobserver agreement for an overall scan impression based on SSTR-RADS was excellent (ICC, 0.88). The SSTR-RADS-based decision to use PRRT also demonstrated excellent agreement, with an ICC of 0.80. No significant differences between experienced and inexperienced readers for an overall scan impression and TL-based SSTR-RADS scoring were observed (P $ 0.18), thereby suggesting that SSTR-RADS seems to be readily applicable even for less experienced readers. Conclusion: SSTR-RADS-guided assessment demonstrated a high concordance rate, even among readers with different levels of experience, supporting the adoption of SSTRRADS for trials, clinical routine, or outcome studies.
KW - Neuroendocrine tumor
KW - Peptide receptor radionuclide therapy
KW - RADS
KW - Reporting and data system
KW - SSTR-RADS
KW - Somatostatin receptor
UR - http://www.scopus.com/inward/record.url?scp=85103683144&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85103683144&partnerID=8YFLogxK
U2 - 10.2967/jnumed.120.245464
DO - 10.2967/jnumed.120.245464
M3 - Article
C2 - 32859702
AN - SCOPUS:85103683144
SN - 0161-5505
VL - 62
SP - 514
EP - 520
JO - Journal of Nuclear Medicine
JF - Journal of Nuclear Medicine
IS - 4
ER -