Assessment of technetium-99m labeled macroaggregated albumin rhinoscintigraphy for the measurement of nasal mucociliary transport rate: intratest, interobserver, and intraobserver reproducibility.

Zeki Dostbil,Mehmet Akdag,Yusuf Dag,Ozlem Cetinkaya,Bekir Tasdemir

doi:10.1155/2014/982515

Zeki Dostbil, Mehmet Akdag + Show 3 more

Open Access

https://doi.org/10.1155/2014/982515

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Journal: Scientifica	Publication Date: Jan 1, 2014
Citations: 11	License type: CC BY 3.0

Affiliation: Dicle University, Harran University

Abstract

Objectives. The measurement of mucociliary transport velocity by rhinoscintigraphy with Tc-99m-macroaggregated albumin (99mTc-MAA) is reliable measure of mucociliary clearance. The aim of this study is to assess the intratest, interobserver, and intraobserver reproducibility of nasal mucociliary transport rate (NMTR) measurement. Materials and Methods. Twenty-two subjects were evaluated to determine intratest reproducibility and a group of 35 subjects was examined to determine inter- and intraobserver reproducibility. Rhinoscintigraphy with 99mTc-MAA was used to measure NMTR in all study subjects. Paired NMTR measurements were compared using a range of statistical methodologies. Intraclass correlation coefficients (ICC) and repeatability coefficients and Bland-Altman plots were applied to assess the degree of intratest, interobserver, and intraobserver variation. Results. Statistical analysis of test and retest experiments demonstrated the statistical equivalence of intratest NMTR measurements, interobserver NMTR measurements, and intraobserver NMTR measurements. The intratest ICC, interobserver ICC, and intraobserver ICC were 0.96, 0.83, and 0.91, respectively, indicating that intratest and intraobserver reproducibility are excellent and interobserver reproducibility is good. Conclusions. Rhinoscintigraphy using 99mTc-MAA results in highly reproducible measurement of NMTR. The use of radionuclide imaging in measuring NMTR results in excellent intratest and intraobserver reproducibility and good interobserver reliability.

Highlights

Nasal mucociliary transport is a physiological process in which the mucus layer of ciliated respiratory epithelium generates movement of particles towards the nasopharynx
The present study demonstrates that the nasal mucociliary transport rate (NMTR) measured using repeated 99mTc-macroaggregated albumin (MAA) rhinoscintigraphy twice in a 4hour interval on the same day did not differ significantly between measurements (P = 0.338)
NMTR did not differ significantly when calculated by two different nuclear medicine specialists on the same patient image (P = 0.211) and two NMTRs calculated by the same specialist at two different time points on the same images did not differ significantly (P = 0.421) (Table 1)

Summary

Introduction

Nasal mucociliary transport is a physiological process in which the mucus layer of ciliated respiratory epithelium generates movement of particles towards the nasopharynx. Functional mucociliary transport results in the entrapment of inhaled foreign particles and their conveyance towards the nasopharynx. This phenomenon is dependent upon the number of functional cilia, beat frequency, and the coordinated movement of the cilia, as well as the secretion of viscoelastic nasal fluid and other factors [1]. Stroboscopy, roentgenography, and photoelectron techniques can be used to evaluate ciliary activity and ciliary beat frequency. Many such techniques are not ideally suited for routine clinical use [3].

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