A Novel Timesaving Method for Hepatobiliary Imaging for Suspected Acute Cholecystitis

• Published in: Current problems in diagnostic radiology Vol. 46; no. 1; pp. 6 - 9
• Main Authors: Carter, Shawn S., MD, Ehsan, S. Ramisa, MD, Duszak, Richard, MD, Lee, Daniel J., MD, Esteves, Fabio P., MD, Brandon, David C., MD, Halkar, Raghuveer K., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-01-2017
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Cholecystitis, Acute - diagnostic imaging; Female; Gallbladder - diagnostic imaging; Humans; Internal Medicine; Male; Middle Aged; Observer Variation; Pilot Projects; Radiology; Radionuclide Imaging; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Young Adult; Cholescintigraphy; Hepatobiliary imaging; Acute cholecystitis
• ISSN: 0363-0188; 1535-6302
• DOI: 10.1067/j.cpradiol.2016.04.005

The purpose of our pilot study was to optimize resource utilization of cholescintigraphy for suspected acute cholecystitis with a novel timesaving method. Hepatobiliary imaging data for 81 patients with suspected acute cholecystitis were recalled for modification into two summed static images, utilizing only the first and last five minutes of the dynamic images, thereby eliminating the middle 50 minutes of imaging data. Two nuclear medicine physicians interpreted the summed images to assess visualization, and those interpretations were compared to the original reports based on using all sixty minutes of dynamic imaging. A third nuclear medicine physician mediated rare inter-reader interpretive disagreements. Comparison of interpretations of timesaving and conventional methods and also inter-observer variability was achieved using the Cohen κ coefficient analysis. Interpretations rendered using the timesaving method showed near perfect agreement with those based on the full dynamic imaging protocol (Cohen κ coefficient = 0.92 for both readers). Furthermore, nuclear medicine physician readers agreed with each other (Cohen κ coefficient = 0.95 between the two readers), indicating minimal inter-observer variability using this novel optimized technique. Our data suggests that in the setting of suspected acute cholecystitis, imaging resource utilization may be improved, via reduced gamma camera and technologist time, using a novel timesaving method without sacrificing diagnostic accuracy.