Evaluation of intravenous radionuclide angiography in detection of occlusive disease of the iliac arteries

Radionuclide angiography (angioscintigraphy) of the iliac arteries was performed in 173 patients consecutively referred for arterial insufficiency of the legs. In 83 of the patients femoral angiography was also performed. The interobserver variation was evaluated by the agreement indices, kappa (K) and weighted kappa (Ksub(w)). For angiography the interobserver agreement was high (K and Ksub(w) 0.65 and 0.77 respectively). For angioscintigraphy the agreement between observers was fair (K = 0.52, Ksub(w) = 0.68)8 and equal to the intraobserver agreement (K = 0.55, Ksub(w) = 0.65). The comparison between angioscintigraphy and angiography gave K-values of 0.22-0.31 and Ksub(w)-values of 0.37-0.48. The nosographic sensitivity of angioscintigraphy was 61%, the nosographic specificity was 93%, and the predictive value for both a positive and a negative test was 83%. The prevalence of occlusion or severe stenosis was 34%. Inguinal pulse palpation detected 48% of iliac occlusions. It is concluded that the reliability of angioscintigraphy in the diagnosis of iliac arterial occlusive disease is acceptable for a non-invasive, rapid, inexpensive and widely available screening procedure. Although anatomical details are not visualized the information obtained is useful for the detailed planning and choice of subsequent diagnostic and therapeutic procedures. The method is well suited for repeat studies and may be modified to include the femoral arteries. (orig.)