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Reliability and reproducibility of interpretation of technetium 99m labeled pyro phosphate myo cardial scintigrams

, : Reliability and reproducibility of interpretation of technetium 99m labeled pyro phosphate myo cardial scintigrams. Clinical Cardiology 2(6): 446-449

The interpretations of 156 99mtechnetium pyrophosphate myocardial scintigrams by 4 observers were analyzed to determine the reliability and reproducibility of the subjective process of reading scintigrams. The scintigrams were scored on an integral scale from 0 to 4, depending upon the degree of myocardial radionuclide accumulation, and the site and nature of uptake were specified. Exact agreement upon score was generally poor but approximate concurrence of interpretation was good (90.4 and 92.5% inter- and intra-observer agreement, respectively). There was somewhat less agreement on scintigrams with the higher scores of 3 and 4 (83.3 and 78.0%, respectively). A high level of concurrence upon the differentiation between diffuse and localized uptake, and upon the site of uptake, was found. Apparently, only approximate rather than exact agreement of individual readers' interpretations can be expected in this subjective technique, scintigrams with higher degrees of radionuclide accumulation produce slightly greater observer disagreement, and variability of interpretation could account for some of the diagnostic inaccuracy of 99mtechnetium pyrophosphate myocardial scintigraphy.


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