TY - JOUR
T1 - Interobserver agreement for the standardized reporting system PSMA-RADS 1.0 on18F-DCFPYL PET/CT imaging
AU - Werner, Rudolf A.
AU - Bundschuh, Ralph A.
AU - Bundschuh, Lena
AU - Javadi, Mehrbod S.
AU - Leal, Jeffrey P.
AU - Higuchi, Takahiro
AU - Pienta, Kenneth J.
AU - Buck, Andreas K.
AU - Pomper, Martin G.
AU - Gorin, Michael A.
AU - Lapa, Constantin
AU - Rowe, Steven P.
N1 - Publisher Copyright:
COPYRIGHT © 2018 by the Society of Nuclear Medicine and Molecular Imaging.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Recently, the standardized reporting and data system for prostate-specific membrane antigen (PSMA)–targeted PET imaging studies, termed PSMA-RADS version 1.0, was introduced. We aimed to determine the interobserver agreement for applying PSMA-RADS to imaging interpretation of18F-DCFPyL (2-(3-{1-carboxy-5-[(6-18F-flu-oro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid) PET examinations in a prospective setting mimicking the typical clinical workflow at a prostate cancer referral center. Methods: Four readers (2 experienced readers (ERs, .3 y of PSMA-targeted PET interpretation experience) and 2 inexperienced readers (IRs,,1 y of experience)), who had all read the initial publication on PSMA-RADS 1.0, assessed 5018F-DCFPyL PET/CT studies independently. Per scan, a maximum of 5 target lesions was selected by the observers, and a PSMA-RADS score for every target lesion was recorded. No specific preexisting conditions were placed on the selection of the target lesions, although PSMA-RADS 1.0 suggests that readers focus on the most avid or largest lesions. An overall scan impression based on PSMA-RADS was indicated, and interobserver agreement rates on a target lesion–based, on an organ-based, and on an overall PSMA-RADS score–based level were computed. Results: The number of target lesions identified by each observer was as follows: ER 1, 123; ER 2, 134; IR 1, 123; and IR 2, 120. Among those selected target lesions, 125 were chosen by at least 2 individual observers (all 4 readers selected the same target lesion in 58 of 125 [46.4%] instances, 3 readers in 40 of 125 [32%], and 2 observers in 27 of 125 [21.6%]). The interobserver agreement for PSMA-RADS scoring among identical target lesions was good (intraclass correlation coefficient [ICC] for 4, 3, and 2 identical target lesions, $0.60, respectively). For lymph nodes, an excellent interobserver agreement was derived (ICC, 0.79). The interobserver agreement for an overall scan impression based on PSMA-RADS was also excellent (ICC, 0.84), with a significant difference for ER (ICC, 0.97) vs. IR (ICC, 0.74) (P 5 0.005). Conclusion: PSMA-RADS demonstrated a high concordance rate in this study, even among readers with different levels of experience. This finding suggests that PSMA-RADS can be effectively used for communication with clinicians and can be implemented in the collection of data for large prospective trials.
AB - Recently, the standardized reporting and data system for prostate-specific membrane antigen (PSMA)–targeted PET imaging studies, termed PSMA-RADS version 1.0, was introduced. We aimed to determine the interobserver agreement for applying PSMA-RADS to imaging interpretation of18F-DCFPyL (2-(3-{1-carboxy-5-[(6-18F-flu-oro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid) PET examinations in a prospective setting mimicking the typical clinical workflow at a prostate cancer referral center. Methods: Four readers (2 experienced readers (ERs, .3 y of PSMA-targeted PET interpretation experience) and 2 inexperienced readers (IRs,,1 y of experience)), who had all read the initial publication on PSMA-RADS 1.0, assessed 5018F-DCFPyL PET/CT studies independently. Per scan, a maximum of 5 target lesions was selected by the observers, and a PSMA-RADS score for every target lesion was recorded. No specific preexisting conditions were placed on the selection of the target lesions, although PSMA-RADS 1.0 suggests that readers focus on the most avid or largest lesions. An overall scan impression based on PSMA-RADS was indicated, and interobserver agreement rates on a target lesion–based, on an organ-based, and on an overall PSMA-RADS score–based level were computed. Results: The number of target lesions identified by each observer was as follows: ER 1, 123; ER 2, 134; IR 1, 123; and IR 2, 120. Among those selected target lesions, 125 were chosen by at least 2 individual observers (all 4 readers selected the same target lesion in 58 of 125 [46.4%] instances, 3 readers in 40 of 125 [32%], and 2 observers in 27 of 125 [21.6%]). The interobserver agreement for PSMA-RADS scoring among identical target lesions was good (intraclass correlation coefficient [ICC] for 4, 3, and 2 identical target lesions, $0.60, respectively). For lymph nodes, an excellent interobserver agreement was derived (ICC, 0.79). The interobserver agreement for an overall scan impression based on PSMA-RADS was also excellent (ICC, 0.84), with a significant difference for ER (ICC, 0.97) vs. IR (ICC, 0.74) (P 5 0.005). Conclusion: PSMA-RADS demonstrated a high concordance rate in this study, even among readers with different levels of experience. This finding suggests that PSMA-RADS can be effectively used for communication with clinicians and can be implemented in the collection of data for large prospective trials.
KW - F-DCFPyL
KW - Interobserver
KW - Interreader
KW - PSMA
KW - PSMA-RADS
KW - Prostate cancer
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U2 - 10.2967/jnumed.118.217588
DO - 10.2967/jnumed.118.217588
M3 - Article
C2 - 30190304
AN - SCOPUS:85057580761
SN - 0161-5505
VL - 59
SP - 1857
EP - 1864
JO - Journal of Nuclear Medicine
JF - Journal of Nuclear Medicine
IS - 12
ER -