{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:33:09Z","timestamp":1777926789446,"version":"3.51.4"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"1181","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Korea Health Industry Development Institute and Daegu Metropolitan city"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study assessed the impact of a structured quantitative analysis program on diagnostic performance, interrater reliability, and reader confidence in interpreting N-3-[18F]fluoropropyl-2\u03b2-carbomethoxy-3\u03b2-4-iodophenyl nortropane positron emission tomography ([18F]FP-CIT PET) scans to differentiate idiopathic Parkinson\u2019s disease from essential tremor-\/drug-induced parkinsonism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective multicenter study included 637 patients who underwent [18F]FP-CIT PET and brain magnetic resonance imaging scans for evaluation of Parkinsonian syndromes at 4 institutions between January 2015 and October 2022. Readers evaluated the scans qualitatively in the pre-program session and with access to quantitative parameters in the post-program session, with a 1-month minimum interval to minimize recall bias. Diagnostic performance metrics (sensitivity, specificity, accuracy), interrater reliability (Cohen\u2019s \u03ba), and reader confidence (low\/moderate vs high) were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Following program implementation, interrater reliability significantly improved from substantial to almost perfect (Cohen\u2019s \u03ba: 0.768-0.970; P\u2009&amp;lt;\u2009.001), and a significant shift toward high-confidence ratings was observed (P\u2009&amp;lt;\u2009.001). Diagnostic accuracy also significantly improved from 92.8% to 94.3% (P\u2009=\u2009.036). Although the increase in the area under the curve (0.922-0.932) did not reach statistical significance (P\u2009=\u2009.163), likely due to a ceiling effect, reader performance significantly surpassed that of the quantitative parameter alone only after program implementation, whereas it was comparable at baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest that integrating quantitative analysis tools may improve diagnostic consistency and reliability in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>The structured quantitative analysis program significantly improved [18F]FP-CIT PET\/CT interpretation by increasing diagnostic accuracy, interrater reliability, and reader confidence.<\/jats:p>\n                  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