Abstract：
OBJECTIVE: The aim of this study was to determine the agreement between three observers with different levels of experience using the PSMA-RADS 2.0 criteria and the miTNM system for the interpretation of PET-PSMA with [18F]DCFPyL in males with prostate cancer.
METHODS: PET-PSMA images from 114 prostate cancer patients were blindly reported twice by three different observers at intervals of 8 weeks. The evaluations were performed according to the molecular imaging TNM (miTNM) and PSMA-RADS 2.0 criteria. We used Fleiss\' Kappa to analyse inter and intraobserver agreements.
RESULTS: Moderate overall agreement was obtained in the assessment of the PET-PSMA results (Fleiss\'k = 0.53; 95% CI 0.45-0.62; p < 0.001), with significant agreement in the miT, miN and miM reports. There was a substantial level of agreement in the reporting of prostatic disease and lymphatic involvement (Fleiss\'k = 0.66 and 0.65), being lower than that observed in the reporting of metastatic disease (Fleiss\'k = 0.86), especially in the M0 group (Fleiss\'k = 0.99). Upon re-evaluation of the images, observer 1 had moderate overall agreement for miT (Fleiss\'k = 0.51) and substantial agreement for miN and miM (Fleiss\'k 0.75 and 0.63, respectively).
CONCLUSIONS: The use of a structured scoring system such as PSMA-RADS 2.0, as well as the miTNM classification system in the interpretation of PET-PSMA images in prostate cancer patients, provides a highly reproducible report format. High levels of interobserver and intraobserver agreement are found, especially when ruling out disease, which supports its use in routine clinical practice.
METHODS: PET-PSMA images from 114 prostate cancer patients were blindly reported twice by three different observers at intervals of 8 weeks. The evaluations were performed according to the molecular imaging TNM (miTNM) and PSMA-RADS 2.0 criteria. We used Fleiss\' Kappa to analyse inter and intraobserver agreements.
RESULTS: Moderate overall agreement was obtained in the assessment of the PET-PSMA results (Fleiss\'k = 0.53; 95% CI 0.45-0.62; p < 0.001), with significant agreement in the miT, miN and miM reports. There was a substantial level of agreement in the reporting of prostatic disease and lymphatic involvement (Fleiss\'k = 0.66 and 0.65), being lower than that observed in the reporting of metastatic disease (Fleiss\'k = 0.86), especially in the M0 group (Fleiss\'k = 0.99). Upon re-evaluation of the images, observer 1 had moderate overall agreement for miT (Fleiss\'k = 0.51) and substantial agreement for miN and miM (Fleiss\'k 0.75 and 0.63, respectively).
CONCLUSIONS: The use of a structured scoring system such as PSMA-RADS 2.0, as well as the miTNM classification system in the interpretation of PET-PSMA images in prostate cancer patients, provides a highly reproducible report format. High levels of interobserver and intraobserver agreement are found, especially when ruling out disease, which supports its use in routine clinical practice.
摘要：
目的：本研究的目的是使用PSMA-RADS2.0标准和miTNM系统对男性前列腺癌患者的PET-PSMA和[18F]DCFPyL的解释，确定具有不同经验水平的三个观察者之间的一致性。
方法：来自114名前列腺癌患者的PET-PSMA图像由三位不同的观察者以8周的间隔进行了两次盲报告。根据分子成像TNM（miTNM）和PSMA-RADS2.0标准进行评估。我们使用Fleiss\'Kappa来分析观察者之间和内部的协议。
结果：在评估PET-PSMA结果时获得了适度的总体一致性（Fleiss\'k=0.53；95％CI0.45-0.62；p<0.001），在MIT上达成了重要协议，miN和miM报告。在前列腺疾病和淋巴受累的报告中有相当大的一致性（Fleiss\'k=0.66和0.65），低于转移性疾病报告中观察到的(Fleiss\'k=0.86)，尤其是在M0组中(Fleiss\'k=0.99)。在重新评估图像时，观察员1对miT有中等总体同意（Fleiss\'k=0.51），对miN和miM有实质性同意（Fleiss\'k分别为0.75和0.63）。
结论：在前列腺癌患者的PET-PSMA图像解释中使用结构化评分系统，如PSMA-RADS2.0，以及miTNM分类系统，提供高度可重复的报告格式。发现了高水平的观察者之间和观察者之间的共识，尤其是当排除疾病时，支持其在常规临床实践中的使用。
方法：来自114名前列腺癌患者的PET-PSMA图像由三位不同的观察者以8周的间隔进行了两次盲报告。根据分子成像TNM（miTNM）和PSMA-RADS2.0标准进行评估。我们使用Fleiss\'Kappa来分析观察者之间和内部的协议。
结果：在评估PET-PSMA结果时获得了适度的总体一致性（Fleiss\'k=0.53；95％CI0.45-0.62；p<0.001），在MIT上达成了重要协议，miN和miM报告。在前列腺疾病和淋巴受累的报告中有相当大的一致性（Fleiss\'k=0.66和0.65），低于转移性疾病报告中观察到的(Fleiss\'k=0.86)，尤其是在M0组中(Fleiss\'k=0.99)。在重新评估图像时，观察员1对miT有中等总体同意（Fleiss\'k=0.51），对miN和miM有实质性同意（Fleiss\'k分别为0.75和0.63）。
结论：在前列腺癌患者的PET-PSMA图像解释中使用结构化评分系统，如PSMA-RADS2.0，以及miTNM分类系统，提供高度可重复的报告格式。发现了高水平的观察者之间和观察者之间的共识，尤其是当排除疾病时，支持其在常规临床实践中的使用。
