OBSERVER VARIATION IN THE INTERPRETATION OF BONE-SCINTIGRAPHY

To assess the reliability of bone scintigraphy, a random sample of 100 bone scans was reviewed twice by each of two physicians. Observer var iation in the description and interpretation of bone scintigrams varie d by diagnosis. Good to excellent kappa values were obtained for inter - and intraobserver variation in relation to metastasis or normal scan s. For degenerative bone disease, as well as the specific agreement on major pathologies other than metastases, re values were found to be m oderate. The agreement on the need for further radiographic studies wa s poor to moderate. The interpretation of bone metastases or normal sc intigrams was found to be more reliable in a research setting than in the usual clinical framework, and the latter requires improvement. The interpretation of bone scintigraphy as consistent with degenerative c hanges is not reliable. The diagnosis should be evaluated by radiograp hy.