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@ARTICLE{Sachpekidis:163653,
      author       = {C. Sachpekidis and R. Schepers and M. Marti and A.
                      Kopp-Schneider$^*$ and I. Alberts and G. Keramida and A.
                      Afshar-Oromieh and A. Rominger},
      title        = {99m{T}c-{MAG}3 {D}iuretic {R}enography: {I}ntra- and
                      {I}nter-{O}bserver {R}epeatability in the {A}ssessment of
                      {R}enal {F}unction.},
      journal      = {Diagnostics},
      volume       = {10},
      number       = {9},
      issn         = {2075-4418},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2020-01931},
      pages        = {709},
      year         = {2020},
      abstract     = {The aim of the present study is to evaluate the intra- and
                      inter-observer agreement in assessing the renal function by
                      means of 99mTc-MAG3 diuretic renography. One hundred and
                      twenty adults were enrolled in the study. One experienced
                      and one junior radiographer processed the renograms twice by
                      assigning manual and semi-automated regions of interest. The
                      differential renal function (DRF, $\%),$ time to maximum
                      counts for the right and left kidney (TmaxR-TmaxL, min) and
                      time to half-peak counts (T1/2, min) were calculated. The
                      Bland-Altman analysis $(bias±95\%$ limits of agreement),
                      Lin's concordance correlation coefficient and weighted
                      Fleiss' kappa coefficient were used to assess agreement.
                      Based on the Bland-Altman analysis, the intra-observer
                      repeatability results for the experienced radiographer using
                      the manual and the semi-automated techniques were 0.2 ±
                      $2.6\%$ and 0.3 ± $6.4\%$ (DRF), respectively, -0.01 ±
                      0.24 and 0.00 ± 0.34 (TmaxR), respectively, and 0.00 ±
                      0.26 and 0.00 ± 0.33 (TmaxL), respectively. For the junior
                      radiographer, the respective results were 0.5 ± $5.0\%$ and
                      0.8 ± $9.4\%$ (DRF), 0.00 ± 0.44 and 0.01 ± 0.28 (TmaxR),
                      and 0.01 ± 0.28 and -0.02 ± 0.44 (TmaxL). The
                      inter-observer repeatability for the manual method was 0.6
                      ± $5.0\%$ (DRF), -0.10 ± 0.42 (TmaxR) and -0.05 ± 0.38
                      (TmaxL), and for the semi-automated method -0.2 ± $9.1\%$
                      (DRF), 0.00 ± 0.31 (TmaxR) and -0.05 ± 0.40 (TmaxL). The
                      weighted Fleiss' kappa coefficient for the T1/2 assessments
                      ranged between 0.85-0.97 for both intra- and inter-observer
                      repeatability with both methods. These findings suggest a
                      very good repeatability in DRF assessment with the manual
                      method-especially for the experienced observer-but a less
                      good repeatability with the semi-automated approach. The
                      calculation of Tmax was also operator-dependent. We conclude
                      that reader experience is important in the calculation of
                      renal parameters. We therefore encourage reader training in
                      renal scintigraphy. Moreover, the manual tool seems to
                      perform better than the semi-automated tool. Thus, we
                      encourage cautious use of automated tools and adjunct
                      validation by manual methods where possible.},
      cin          = {C060},
      ddc          = {610},
      cid          = {I:(DE-He78)C060-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32957695},
      doi          = {10.3390/diagnostics10090709},
      url          = {https://inrepo02.dkfz.de/record/163653},
}