Interobserver Variability in Cardiovascular FDG PET/CT Analysis in Large Vessel Vasculitis

Introduction: PET/CT has a synergistic value for optimal diagnosis, disease activity monitoring, and evaluation of damage progression in large vessel vasculitis. The use of standardized uptake values (SUV) as a measurement of relative tissue uptake facilitates comparisons between patients, and has b...

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Main Authors: Redemptar Kimeu, Anoop Shah, Samuel Gitau, Gemina Doolub, Jeilan Mohamed
Format: Article
Language:English
Published: Ubiquity Press 2025-05-01
Series:Global Heart
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Online Access:https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1433
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author Redemptar Kimeu
Anoop Shah
Samuel Gitau
Gemina Doolub
Jeilan Mohamed
author_facet Redemptar Kimeu
Anoop Shah
Samuel Gitau
Gemina Doolub
Jeilan Mohamed
author_sort Redemptar Kimeu
collection DOAJ
description Introduction: PET/CT has a synergistic value for optimal diagnosis, disease activity monitoring, and evaluation of damage progression in large vessel vasculitis. The use of standardized uptake values (SUV) as a measurement of relative tissue uptake facilitates comparisons between patients, and has been suggested as a basis for diagnosis. The SUVmean and SUVmax reproducibility in vascular structures is not widely studied. Objective: The objective of this study was to evaluate the inter-observer variability of both qualitative visual grading of aortic 18F-FDG uptake and the quantitative aortic mean and maximum SUVs in these patients with mild to moderate covid-19 infection who underwent multimodality cardiac imaging within the COSMIC-19 trial. Study design: This is a sub-study of the COSMIC-19 trial. 30 patients were subjected to a combined Computed Tomography Coronary Angiogram and 18F-FDG PET/CT, followed by cardiac magnetic resonance. Two independent observers measured the Standardized uptake values in five regions of interest at each aortic segment. These were performed sequentially along the length of the aorta every 5 mm on the axial slices. The maximum and mean standard uptake values were measured. Results: Qualitative assessment showed excellent agreement between observer x and y for the ascending aorta and aortic arch regions with the kappa coefficients for the inter observer agreement of 0.92 (95% CI:0.78–1.0) and 0.91 (95% CI:0.74–1.0) respectively. Quantitative assessment showed a very high positive correlation between the two observers for each of the regions measured for SUVmean as follows; ascending aorta r = 0.96 (p < 0.001), Aortic arch r = 0.90 (p < 0.001) and descending Aorta r = 0.91 (p < 0.001). The correlation coefficients for the SUVmax were substantially strong. Conclusion: This study shows an excellent inter-observer reproducibility for both qualitative and quantitative SUVmean vascular 18F-FDG measurements in patients with COVID-19 large vessel vasculitis. Quantitative SUVmax demonstrated substantially strong interobserver reproducibility.
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spelling doaj-art-1093dff6a6d645a3b6e969ac3ff27bde2025-08-20T03:21:06ZengUbiquity PressGlobal Heart2211-81792025-05-01201484810.5334/gh.14331414Interobserver Variability in Cardiovascular FDG PET/CT Analysis in Large Vessel VasculitisRedemptar Kimeu0https://orcid.org/0000-0001-5641-5924Anoop Shah1https://orcid.org/0000-0002-2825-3419Samuel Gitau2https://orcid.org/0000-0002-8908-4735Gemina Doolub3https://orcid.org/0000-0002-3089-2690Jeilan Mohamed4https://orcid.org/0000-0003-4812-9260The Nairobi Hospital, NairobiLondon School of Hygiene and Tropical MedicineAgakhan university hospital, NairobiTranslational Health Sciences, University of BristolAgakhan University Hospital, NairobiIntroduction: PET/CT has a synergistic value for optimal diagnosis, disease activity monitoring, and evaluation of damage progression in large vessel vasculitis. The use of standardized uptake values (SUV) as a measurement of relative tissue uptake facilitates comparisons between patients, and has been suggested as a basis for diagnosis. The SUVmean and SUVmax reproducibility in vascular structures is not widely studied. Objective: The objective of this study was to evaluate the inter-observer variability of both qualitative visual grading of aortic 18F-FDG uptake and the quantitative aortic mean and maximum SUVs in these patients with mild to moderate covid-19 infection who underwent multimodality cardiac imaging within the COSMIC-19 trial. Study design: This is a sub-study of the COSMIC-19 trial. 30 patients were subjected to a combined Computed Tomography Coronary Angiogram and 18F-FDG PET/CT, followed by cardiac magnetic resonance. Two independent observers measured the Standardized uptake values in five regions of interest at each aortic segment. These were performed sequentially along the length of the aorta every 5 mm on the axial slices. The maximum and mean standard uptake values were measured. Results: Qualitative assessment showed excellent agreement between observer x and y for the ascending aorta and aortic arch regions with the kappa coefficients for the inter observer agreement of 0.92 (95% CI:0.78–1.0) and 0.91 (95% CI:0.74–1.0) respectively. Quantitative assessment showed a very high positive correlation between the two observers for each of the regions measured for SUVmean as follows; ascending aorta r = 0.96 (p < 0.001), Aortic arch r = 0.90 (p < 0.001) and descending Aorta r = 0.91 (p < 0.001). The correlation coefficients for the SUVmax were substantially strong. Conclusion: This study shows an excellent inter-observer reproducibility for both qualitative and quantitative SUVmean vascular 18F-FDG measurements in patients with COVID-19 large vessel vasculitis. Quantitative SUVmax demonstrated substantially strong interobserver reproducibility.https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1433vasculitisfgd/ct petlarge vessel vasculitisinterobserver variabilitystandardized uptake values
spellingShingle Redemptar Kimeu
Anoop Shah
Samuel Gitau
Gemina Doolub
Jeilan Mohamed
Interobserver Variability in Cardiovascular FDG PET/CT Analysis in Large Vessel Vasculitis
Global Heart
vasculitis
fgd/ct pet
large vessel vasculitis
interobserver variability
standardized uptake values
title Interobserver Variability in Cardiovascular FDG PET/CT Analysis in Large Vessel Vasculitis
title_full Interobserver Variability in Cardiovascular FDG PET/CT Analysis in Large Vessel Vasculitis
title_fullStr Interobserver Variability in Cardiovascular FDG PET/CT Analysis in Large Vessel Vasculitis
title_full_unstemmed Interobserver Variability in Cardiovascular FDG PET/CT Analysis in Large Vessel Vasculitis
title_short Interobserver Variability in Cardiovascular FDG PET/CT Analysis in Large Vessel Vasculitis
title_sort interobserver variability in cardiovascular fdg pet ct analysis in large vessel vasculitis
topic vasculitis
fgd/ct pet
large vessel vasculitis
interobserver variability
standardized uptake values
url https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1433
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AT anoopshah interobservervariabilityincardiovascularfdgpetctanalysisinlargevesselvasculitis
AT samuelgitau interobservervariabilityincardiovascularfdgpetctanalysisinlargevesselvasculitis
AT geminadoolub interobservervariabilityincardiovascularfdgpetctanalysisinlargevesselvasculitis
AT jeilanmohamed interobservervariabilityincardiovascularfdgpetctanalysisinlargevesselvasculitis