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CC BY-NC-ND 4.0 · World J Nucl Med 2021; 20(01): 38-45
DOI: 10.4103/wjnm.WJNM_37_20
Original Article

Intraobserver and interobserver variations in cortical transit time measurement in children with pelviureteric junction obstruction

Vishesh Jain
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
,
Rakesh Kumar
1   Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
,
Shamim Shamim
1   Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
,
Saurabh Arora
1   Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
,
Kalaivani Mani
2   Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
,
Devendra Yadav
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
,
Prabudh Goel
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
,
Anjan Dhua
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
,
Sandeep Agarwala
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
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Abstract

Cortical transit time (CTT) has recently been shown to be a useful parameter in the management of children with pelviureteric junction obstruction (PUJO). The aim of this study was to assess intraobserver and interobserver variations in the qualitative and quantitative assessment of CTT in children with PUJO. A retrospective study was performed, and 99mTc-MAG3 renogram images of all children with PUJO performed from January 2016 to December 2017 were retrieved. The images were assessed by three observers at two different time points. CTT was qualified as delayed if CTT was more than 3 min else; it was noted as normal. The intraobserver and interobserver variations in the results of the CTT of the normal kidney and affected kidney both before and after surgery were studied. The kappa statistic was used to compare the interobserver variation of qualitative interpretation of CTT. The Bland–Altman plot was used to evaluate the intraobserver and interobserver variations of the quantitative interpretation of CTT. A total of 57 99mTc-MAG3 renal scintigraphies were evaluated. Overall, 114 renal units were evaluated with 51 normal renal units and 63 renal units with PUJO. Of these, 63 renal units with PUJO, 31 renal units had been operated upon, whereas the remaining 32 renal units had no intervention at the time of the study. The kappa statistic in the normal, affected operated, and affected unoperated kidneys was interpreted as almost perfect, substantial to almost perfect, and moderate to substantial level of agreement, respectively. The Bland–Altman plot revealed a large mean difference and wide 95% limits of agreement in affected kidneys (both operated and unoperated). The study concludes that the qualitative CTT interpretation in the affected renal unit which is most commonly used in recent studies is a reliable and reproducible parameter in children with PUJO. The quantitative measurement had wide inter- and intraobserver variation for clinical use.

Keywords

Cortical transit time - hydronephrosis - pelviureteric junction obstruction - pyeloplasty - renogram

Financial support and sponsorship

The study was funded by the intramural research project grant, Organization: All India Institute of Medical Sciences, Place: New Delhi.




Publication History

Received: 16 May 2020

Accepted: 25 May 2020

Article published online:
30 March 2022

© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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