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Automatic Quantification of Myocardial Perfusion Stress–Rest Change: A New Measure of Ischemia

¹ Departments of Imaging and Medicine, Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, California
² Departments of Diagnostic Radiology and Nuclear Medicine, University of Western Ontario, London, Canada

View larger version (24K): [in a new window]   FIGURE 1. ISCH area under the ROC curve expressed as a function of the change threshold used in the calculation of ISCH. For reference, areas under the ROC curves obtained by visual analysis are shown as straight lines.

View larger version (20K): [in a new window]   FIGURE 2. Comparison of the ROC curves for ISCH with SSS, QSSS, and stress extent measures for the prediction of 50% (A) and 70% (B) coronary artery stenosis.

View larger version (17K): [in a new window]   FIGURE 3. Comparison of the ROC curves for ISCH with SDS and QSDS measures for the prediction of 50% (A) and 70% (B) coronary artery stenosis.

View larger version (48K): [in a new window]   FIGURE 4. Short-axis (left) and vertical long-axis (right) slices in a typical patient with stress-induced ischemia and no infarct.

View larger version (47K): [in a new window]   FIGURE 5. Visualization of the stress–rest change estimated to be 4.5% by ISCH: (A) 99mTc stress images with stress contours, (B) coregistered 201Tl REST images with stress contours, (C) change counts displayed within the contour (partial-volume effect causes some voxels to be partially outside the contour), and (D) fused display of normalized change counts with stress images.