The impact of regional 99mTc-HMPAO single-photon-emission computed tomography (SPECT) imaging on clinician diagnostic confidence in a mixed cognitive impairment sample
The impact of regional 99mTc-HMPAO single-photon-emission computed tomography (SPECT) imaging on clinician diagnostic confidence in a mixed cognitive impairment sample
AIM:To assess the clinical impact of regional cerebral blood flow (rCBF) single-photon-emission computed tomography (SPECT) imaging on diagnosis and clinician diagnostic confidence in a cohort of individuals with cognitive impairment.
MATERIALS AND METHODS:Forty-one clinicians who referred 79 patients for a [99mTc]-hexamethylpropyleneamine oxime (HMPAO) SPECT for cognitive complaints completed a two-part questionnaire to determine the diagnosis and diagnostic confidence (using a 0-100 visual analogue scale [VAS]) before and after imaging. SPECT images were analysed using statistical parametric mapping and interpreted semi-quantitatively. Clinicians were also asked directly for their opinion on whether the imaging contributed to their diagnostic process.
RESULTS:Diagnosis changed after imaging in 44% of cases, and confidence was significantly improved (VAS score change= +26.3±22.2) after imaging in cases where the pre-imaging confidence was low (p<0.001). Clinician confidence was not significantly different (VAS score change=-6.6±25.5) after imaging when pre-imaging confidence was moderate to high. Interestingly, a proportion of clinicians with the highest confidence levels became less certain about their diagnosis following imaging results. When asked directly, 96% of clinicians stated that the imaging contributed to the diagnostic process.
CONCLUSIONS:In a mixed clinical cognitive impairment cohort, perfusion SPECT is valued by referring clinicians and contributes to diagnostic decision making. Imaging is of particular value when diagnostic confidence is low prior to imaging
714.e7-714.e14
Prosser, A.M.J.
de1efee5-67f5-478e-8cfa-12a8e78a68e5
Tossici-Bolt, L.
5bb6c0b3-3ba7-4ffc-9922-8f9cdb9f5829
Kipps, C.M.
e43be016-2dc2-45e6-9a02-ab2a0e0208d5
September 2020
Prosser, A.M.J.
de1efee5-67f5-478e-8cfa-12a8e78a68e5
Tossici-Bolt, L.
5bb6c0b3-3ba7-4ffc-9922-8f9cdb9f5829
Kipps, C.M.
e43be016-2dc2-45e6-9a02-ab2a0e0208d5
Prosser, A.M.J., Tossici-Bolt, L. and Kipps, C.M.
(2020)
The impact of regional 99mTc-HMPAO single-photon-emission computed tomography (SPECT) imaging on clinician diagnostic confidence in a mixed cognitive impairment sample.
Clinical Radiology, 75 (9), .
(doi:10.1016/j.crad.2020.04.016).
Abstract
AIM:To assess the clinical impact of regional cerebral blood flow (rCBF) single-photon-emission computed tomography (SPECT) imaging on diagnosis and clinician diagnostic confidence in a cohort of individuals with cognitive impairment.
MATERIALS AND METHODS:Forty-one clinicians who referred 79 patients for a [99mTc]-hexamethylpropyleneamine oxime (HMPAO) SPECT for cognitive complaints completed a two-part questionnaire to determine the diagnosis and diagnostic confidence (using a 0-100 visual analogue scale [VAS]) before and after imaging. SPECT images were analysed using statistical parametric mapping and interpreted semi-quantitatively. Clinicians were also asked directly for their opinion on whether the imaging contributed to their diagnostic process.
RESULTS:Diagnosis changed after imaging in 44% of cases, and confidence was significantly improved (VAS score change= +26.3±22.2) after imaging in cases where the pre-imaging confidence was low (p<0.001). Clinician confidence was not significantly different (VAS score change=-6.6±25.5) after imaging when pre-imaging confidence was moderate to high. Interestingly, a proportion of clinicians with the highest confidence levels became less certain about their diagnosis following imaging results. When asked directly, 96% of clinicians stated that the imaging contributed to the diagnostic process.
CONCLUSIONS:In a mixed clinical cognitive impairment cohort, perfusion SPECT is valued by referring clinicians and contributes to diagnostic decision making. Imaging is of particular value when diagnostic confidence is low prior to imaging
Text
ProsserAMJ_2020_ClinRad_HMPAO-SPECT_impact
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Accepted/In Press date: 28 April 2020
e-pub ahead of print date: 4 June 2020
Published date: September 2020
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Funding Information:
This report is independent research funded by the National Institute for Health Research Applied Research Collaboration Wessex (NIHR ARC Wessex) . The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.
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© 2020 The Royal College of Radiologists
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Local EPrints ID: 442094
URI: http://eprints.soton.ac.uk/id/eprint/442094
ISSN: 0009-9260
PURE UUID: 53f3ef4d-e767-48e1-83b6-fe69ffa31356
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Date deposited: 07 Jul 2020 16:49
Last modified: 21 Nov 2024 05:01
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Author:
L. Tossici-Bolt
Author:
C.M. Kipps
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