Comparison of 3 Interpretation Criteria for 68 Ga-PSMA11 PET Based on Inter- and Intrareader Agreement
Open accessAbstract
PET using radiolabeled prostate-specific membrane antigen (PSMA) is now being more widely adopted as a valuable tool to evaluate patients with prostate cancer (PC). Recently, 3 different criteria for interpretation of PSMA PET were published: the European Association of Nuclear Medicine (EANM) criteria, the Prostate Cancer Molecular Imaging Standardized Evaluation criteria, and the PSMA Reporting and Data System. We compared these 3 criteria in terms of interreader, intrareader, and intercriteria agreement. Methods: Data from 104 patients prospectively enrolled in research protocols at our institution were retrospectively reviewed. The cohort consisted of 2 groups: 47 patients (mean age, 64.2 y old) who underwent Glu-NH-CO-NH-Lys-(Ahx)-[68Ga(HBED-CC)] (68Ga-PSMA11) PET/MRI for initial staging of biopsy-proven intermediate- or high-risk PC, and 57 patients (mean age, 70.5 y old) who underwent 68Ga-PSMA11 PET/CT because of biochemically recurrent PC. Three nuclear medicine physicians independently evaluated all 68Ga-PSMA11 PET/MRI and PET/CT studies according to the 3 interpretation criteria. Two of them reevaluated all studies 6 mo later in the same manner and masked to the initial reading. The Gwet agreement coefficient was calculated to evaluate interreader, intrareader, and intercriteria agreement based on the following sites: local lesion (primary tumor or prostate bed after radical prostatectomy), lymph node metastases, and other metastases. Results: In the PET/MRI group, interreader, intrareader, and intercriteria agreement ranged from substantial to almost perfect for any site according to all 3 criteria. In the PET/CT group, interreader agreement ranged from substantial to almost perfect except for judgment of distant metastases based on the PSMA Reporting and Data System (Gwet agreement coefficient, 0.57; moderate agreement), in which the most frequent cause of disagreement was lung nodules. Intrareader agreement ranged from substantial to almost perfect for any site according to all 3 criteria. Intercriteria agreement for each site was also substantial to almost perfect. Conclusion: Although the 3 published criteria have good interreader and intrareader reproducibility in evaluating 68Ga-PSMA11 PET, there are some factors causing interreader disagreement. Further work is needed to address this issue.
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Similar degrees of inter-reader agreement were achieved with different reporting criteria.
“Similar degrees of inter-reader agreement were achieved with different reporting criteria [224].”
From Influences on PET Quantification and Interpretation (2022) · cites this paper as [224]
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- Authors
- Toriihara, A., Nobashi, T., Baratto, L., Duan, H., Moradi, F., Park, S., Hatami, N., Aparici, C. M., Davidzon, G., & Iagaru, A.
- Affiliations
- Stanford Medicine (US)
- ORCID
- Venue
- Journal of Nuclear Medicine
- Publisher
- Society of Nuclear Medicine
- Published
- 2019-09-27
- Volume
- 61
- Issue
- 4
- Pages
- 533-539
- ISSN
- 0161-5505 (ISSN-L)
- 2159-662X
- OpenAlex
- W2976800780
- Cited by
- 53
- References
- 36
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 6 · 2023: 10 · 2022: 12 · 2021: 12 · 2020: 4
- FWCI
- 5.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Nuclear Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Keywords
- prostate-specific membrane antigen, prostate cancer, interobserver agreement, biochemical recurrence, lymph node metastasis, distant metastasis, pulmonary nodules, PET/MRI, PET/CT
- MeSH terms
- Aged, Edetic Acid, Gallium Isotopes, Gallium Radioisotopes, Humans, Image Interpretation, Computer-Assisted, Magnetic Resonance Imaging, Male, Oligopeptides, Prostatic Neoplasms, Observer Variation, Positron-Emission Tomography, Multimodal Imaging
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