<sup>68</sup>Ga-DOTATATE PET/CT Interobserver Agreement for Neuroendocrine Tumor Assessment: Results of a Prospective Study on 50 Patients
Bibliographic record
Abstract
We evaluated observer agreement for 68 Ga-DOTATATE PET/CT interpretations in patients with neuroendocrine tumor (NET). Methods: 68 Ga-DOTATATE PET/CT was performed on 50 patients with known or suspected NET of the small bowel (n 5 19), pancreas (n 5 14), lung (n 5 4), or other location (n 5 13). The images were reviewed by 7 observers, who used a standardized interpretation approach. The observers were classified as having a low level of experience (,500 scans or ,5 y experience with 68 Ga-DOTATATE PET/CT; n 5 4) or a high level of experience ($500 scans or $5 y experience with 68 Ga-DOTATATE PET/CT; n 5 3). Interpretation by the primary nuclear medicine physician, who had access to all clinical and imaging data, served as the reference standard. Interobserver agreement was determined by the Cohen k statistic and intraclass correlation coefficient (ICC) with corresponding 95% confidence interval (95%CI). Results: Interobserver agreement was substantial, and the median number of false findings was low for the overall scan result: that is, positive versus negative scan result (k 5 0.80; 95%CI, 0.74-0.86; false findings, 3), organ involvement (k 5 0.70; 95%CI, 0.64-0.76; false findings, 5), and lymph node involvement (k 5 0.71; 95%CI, 0.65-0.78; false findings, 6). Interobserver agreement was substantial to almost perfect, and the average absolute difference (D) from the reference observer was low for number of organ and lymph node metastases (organ: ICC, 0.84; 95%CI, 0.77-0.89; D 5 0.45; lymph node: ICC, 0.77; 95%CI, 0.69-0.84; D 5 0.45), tumor SUV max (ICC, 0.99; 95%CI, 0.97-0.99; D 5 0.44), and reference SUV (spleen: ICC, 0.81; D 5 1.10; liver: ICC, 0.79; D 5 0.62). Interpretations of appropriateness for peptide-receptor radionuclide therapy varied more significantly among observers (k 5 0.64; 95%CI, 0.57-0.70), and a higher frequency of false-positive recommendations for peptide-receptor radionuclide therapy occurred in observers with low experience than in those with high experience (range, 7-12 vs. 4-8). Conclusion: The interpretation of 68 Ga-DOTATATE PET/CT images for NET staging is consistent among observers with low and high levels of experience. However, image-based recommendations for or against peptide-receptor radionuclide therapy require experience and training.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".