A Novel Timesaving Method for Hepatobiliary Imaging for Suspected Acute Cholecystitis

Curr Probl Diagn Radiol. 2017 Jan-Feb;46(1):6-9. doi: 10.1067/j.cpradiol.2016.04.005. Epub 2016 May 11.


Objective: To optimize resource utilization of cholescintigraphy for suspected acute cholecystitis with a time-saving method without a loss in diagnostic accuracy.

Materials and methods: Institutional review board approval was obtained for this retrospective study. Hepatobiliary imaging data for 81 patients with suspected acute cholecystitis were recalled for modification into 2 summed static images, using only the first and last 5 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 60 minutes of dynamic imaging. A third nuclear medicine physician mediated rare inter-reader interpretive disagreements. Comparison of interpretations of time-saving and conventional methods and also inter-observer variability was achieved using the Cohen κ coefficient analysis.

Results: Interpretations rendered using the time-saving 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 2 readers), indicating minimal inter-observer variability using this novel optimized technique.

Conclusion: In the setting of suspected acute cholecystitis, imaging resource utilization may be improved, via reduced gamma camera and technologist time, using a novel time-saving method without sacrificing diagnostic accuracy. Multicenter larger trials, however, will be necessary to establish reproducibility.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cholecystitis, Acute / diagnostic imaging*
  • Female
  • Gallbladder / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Pilot Projects
  • Radionuclide Imaging
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Young Adult