Inter-operator variability in compartmental kinetic analysis of 18F-fluoromisonidazole dynamic PET

Clin Imaging. 2018 May-Jun;49:121-127. doi: 10.1016/j.clinimag.2017.12.015. Epub 2018 Jan 12.


Purpose: To assess the inter-operator variability in compartment analysis (CA) of dynamic-FMISO (dyn-FMISO) PET.

Methods: Study-I: Five investigators conducted CA for 23 NSCLC dyn-FMISO tumor time-activity-curves. Study-II: Four operators performed CA for four NSCLC dyn-FMISO datasets. Repeatability of Kinetic-Rate-Constants (KRCs) was assessed.

Results: Study-I: Strong correlation (ICC > 0.9) and interchangeable results among operators existed for all KRCs. Study-II: Up to 103% variability in tumor segmentation, and weaker ICC in KRCs (ICC-VB = 0.53; ICC-K1 = 0.91; ICC-K1/k2 = 0.25; ICC-k3 = 0.32; ICC-Ki = 0.54) existed. All KRCs were repeatable among the different operators.

Conclusions: Inter-operator variability in CA of dyn-FMISO was shown to be within statistical errors.

Keywords: Dynamic PET; Kinetic analysis; Variability.

MeSH terms

  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging*
  • Humans
  • Lung Neoplasms / diagnostic imaging*
  • Misonidazole / analogs & derivatives*
  • Misonidazole / pharmacokinetics
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals / pharmacokinetics*


  • Radiopharmaceuticals
  • fluoromisonidazole
  • Misonidazole