Powered by LatticeGrid

Search Enter term and hit return. Use '*' for as a wildcard.
Miller MP, Kostakoglu L, Pryma D, Yu JQ, Chau A, Perlman E, Clarke B, Rosen D, Ward P
Reader training for the re-staging of biochemically recurrent prostate cancer using fluciclovine (18F) PET/CT
J Nucl Med (2017) 58:1596-1602.
Fluciclovine (18F) is a novel positron emission tomography (PET)/computerised tomography (CT) tracer. This blinded image evaluation (BIE) sought to demonstrate that, after limited training, readers naive to fluciclovine (18F), could interpret fluciclovine (18F) images from subjects with biochemical recurrent (BCR) prostate cancer with acceptable diagnostic performance and reproducibility. The primary objectives were to establish individual readers' diagnostic performance and the overall interpretation (2/3 reader concordance) compared to standard of truth (SOT) data (histopathology and/or clinical follow-up) and to evaluate inter-reader reproducibility. Secondary objectives included comparison to the expert reader and assessment of intra-reader reproducibility. Methods: Fluciclovine (18F) PET/CT images (n = 121) and corresponding SOT were collected from 110 subjects at Emory University, USA using a single-timepoint static acquisition starting 5 minutes post-injection of ~370 MBq fluciclovine (18F). Three readers were trained using standardised interpretation methodology and subsequently evaluated the images in a blinded manner. Analyses were conducted at the lesion, region (prostate, including bed & seminal vesicle, or extra-prostatic, including all lymph nodes, bone or soft tissue metastasis), and subject level. Results: Lesion-level overall positive predictive value (PPV) was 70.5%. The readers' PPV and negative predictive value (NPV) were broadly consistent with each other and with the onsite read. Sensitivity was highest for Readers 1 and 2 (68.5% and 63.9% respectively) whereas specificity was highest for Reader 3 (83.6%). Overall, prostate-level sensitivity was high (91.4%), but specificity was moderate (48.7%). Inter-reader agreement was 94.7%, 74.4%, 70.3% for the lesion, prostate and extra-prostatic levels, respectively, with associated Fleiss' kappa values of 0.54, 0.50 and 0.57. Intra-reader agreement was 97.8%, 96.9%, 99.1% at the lesion level, 100%, 100%, 91.7% in the prostate region and 83.3%, 75.0%, 83.3% in the extra-prostatic region for Readers 1, 2 and 3, respectively. Concordance between the BIE and the onsite reader exceeded 75% for each reader at the lesion, region and subject levels. Conclusion: Specific training in the use of standardised interpretation methodology for assessment of fluciclovine (18F) PET/CT images enables naive readers to achieve acceptable diagnostic performance and reproducibility when staging recurrent prostate cancer.
Publication Date: 2017-10-01.
Last updated on Saturday, August 15, 2020