C-X-C基序趋化因子受体4(CXCR4)指导的分子成像在边缘区淋巴瘤(MZL)患者中提供了出色的读出能力。我们旨在确定具有不同经验水平的读者之间CXCR4靶向PET/CT的观察者间一致率。
方法:50例MZL患者接受了CXCR4靶向PET/CT,由四名读者(包括两名经验丰富的和两名经验不足的观察者)进行了审查。调查了以下8个参数:总体扫描结果,淋巴瘤组织中的CXCR4密度,结外器官受累,不。受影响的结外器官和结外器官转移,淋巴结(LN)受累和编号。受影响的LN区域和LN转移。我们应用了组内相关系数(ICC;<0.4,差;0.4-0.59,一般;0.6-0.74,良好和>0.74优秀协议率)。
结果:在所有读者中,公平协议记录为第受影响的结外器官(ICC,0.40;95%置信区间[CI],0.25-0.68),总体扫描结果(ICC,0.42;95CI,0.28-0.57),淋巴瘤组织中的CXCR4密度(ICC,0.52;95CI,0.38-0.66),和不。结外器官转移(ICC,0.55;95CI,0.41-0.61)和LN参与(ICC,0.59;95CI,0.46-0.71)。观察到良好的协议率。LN转移(ICC,0.71;95CI,0.60-0.81)和编号。LN地区(ICC,0.73;95CI,0.63-0.82),而结外器官受累(ICC,0.35;95CI,0.21-0.51)一致性差。在读者之间的比较中,有经验的读者在4/8(50%)调查的扫描项目(ICC,范围,0.21-0.90,P=0.04)。在剩下的4/8(50%)中,记录到有经验的读者的ICC较高的类似趋势(n.s.)。
结论:CXCR4导向的PET/CT主要为扫描评估提供了良好的一致率,而准确的成像读数似乎需要相关水平的经验。
C-X-C motif chemokine receptor 4 (CXCR4)-directed molecular imaging provides excellent read-out capabilities in patients with marginal zone lymphoma (MZL). We aimed to determine the interobserver agreement rate of CXCR4-targeted PET/CT among readers with different levels of experience.
METHODS: 50 subjects with MZL underwent CXCR4-targeted PET/CT, which were reviewed by four readers (including two experienced and two less experienced observers). The following 8 parameters were investigated: overall scan result, CXCR4 density in lymphoma tissue, extranodal organ involvement, No. of affected extranodal organs and extranodal organ metastases, lymph node (LN) involvement and No. of affected LN areas and LN metastases. We applied intraclass correlation coefficients (ICC; < 0.4, poor; 0.4-0.59, fair; 0.6-0.74, good and > 0.74 excellent agreement rates).
RESULTS: Among all readers, fair agreement was recorded for No. of affected extranodal organs (ICC, 0.40; 95% confidence interval [CI], 0.25-0.68), overall scan result (ICC, 0.42; 95%CI, 0.28-0.57), CXCR4 density in lymphoma tissue (ICC, 0.52; 95%CI, 0.38-0.66), and No. of extranodal organ metastases (ICC, 0.55; 95%CI, 0.41-0.61) and LN involvement (ICC, 0.59; 95%CI, 0.46-0.71). Good agreement rates were observed for No. of LN metastases (ICC, 0.71; 95%CI, 0.60-0.81) and No. of LN areas (ICC, 0.73; 95%CI, 0.63-0.82), while extranodal organ involvement (ICC, 0.35; 95%CI, 0.21-0.51) achieved poor concordance. On a reader-by-reader comparison, the experienced readers achieved significantly higher agreement rates in 4/8 (50%) investigated scan items (ICC, range, 0.21-0.90, P < / = 0.04). In the remaining 4/8 (50%), a similar trend with higher ICCs for the experienced readers was recorded (n.s.).
CONCLUSIONS: CXCR4-directed PET/CT mainly provided fair to good agreement rates for scan assessment, while a relevant level of experience seems to be required for an accurate imaging read-out.