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Human-Observer Receiver-Operating-Characteristic Evaluation of Attenuation, Scatter, and Resolution Compensation Strategies for ^99mTc Myocardial Perfusion Imaging

¹ Division of Nuclear Medicine, Department of Radiology, University of Massachusetts Medical School, Worcester, Massachusetts
² Division of Cardiology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

View larger version (92K): [in a new window]   FIGURE 1. GUI used in ROC studies. Top 3 panels display SA, HLA, and VLA slices, from top to bottom, for interpretation by observer. Three pull-down buttons shown on polar map marking 3 arterial territories (middle panel at bottom) allowed user to assign score to each vascular territory (LAD, LCx, and RCA). During training, feedback regarding presence or absence of defect would appear in right panel at bottom of interface after observer completed assigning scores as described in text. Instructions for observer were given in left panel at bottom.

View larger version (135K): [in a new window]   FIGURE 2. Comparison of SA slices of FBP (first row), OSEM with AC (second row), OSEM with AC + SC (third row), and OSEM with AC + SC + RC (fourth row) reconstructions for patient with low likelihood of CAD. Note that inferior wall cooling artifact associated with subdiaphragmatic attenuation and presence of extracardiac activity, although present in FBP images, is absent in corrected images. Enhanced levels of extracardiac activity were seen in OSEM images with AC alone, in contrast to OSEM images with both AC + SC and AC + SC + RC.

View larger version (19K): [in a new window]   FIGURE 3. Comparison of ROC curves for overall detection of CAD (averaged over 7 observers) for FBP, OSEM with AC, OSEM with AC + SC, and OSEM with AC + SC + RC. TPF = true-positive fraction; FPF = false-positive fraction.

View larger version (19K): [in a new window]   FIGURE 4. Average ROC curves for LAD localization for FBP, OSEM with AC, OSEM with AC + SC, and OSEM with AC + SC + RC. TPF = true-positive fraction; FPF = false-positive fraction.

View larger version (18K): [in a new window]   FIGURE 5. Average ROC curves for LCx localization for FBP, OSEM with AC, OSEM with AC + SC, and OSEM with AC + SC + RC. TPF = true-positive fraction; FPF = false-positive fraction.

View larger version (19K): [in a new window]   FIGURE 6. Average ROC curves for RCA localization for FBP, OSEM with AC, OSEM with AC + SC, and OSEM with AC + SC + RC. TPF = true-positive fraction; FPF = false-positive fraction.