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Prognostic Value of Automated Quantification of 99mTc-Sestamibi Myocardial Perfusion Imaging

William D. Leslie, MD1,2, Shawn A. Tully, MD2, Marina S. Yogendran, MSc3, Linda M. Ward, RT (NM)2, Khaled A. Nour, MD2 and Colleen J. Metge, PhD3,4

1 Section of Nuclear Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
2 Department of Nuclear Medicine, St. Boniface General Hospital, Winnipeg, Manitoba, Canada
3 Manitoba Centre for Health Policy, Winnipeg, Manitoba, Canada
4 Faculty of Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada



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  		FIGURE 1. Cumulative survival without AMI or cardiac death according to visual interpretation (normal vs. abnormal) (A) or automated quantitative assessment (SSS ≤ 3 vs. SSS > 3) of myocardial perfusion scintigraphy (B).

 


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  		FIGURE 2. Cumulative survival without AMI or cardiac death according to visual interpretation (reversibility vs. no reversibility) (A) or automated quantitative assessment (SDS ≤ 2 vs. SDS > 2) of myocardial perfusion scintigraphy (B).

 


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  		FIGURE 3. Cumulative survival without AMI or cardiac death according to severity class of automated SSS (A) and severity class of automated SDS (B).

 


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  		FIGURE 4. Cumulative survival without AMI or cardiac death according to agreement between visual assessment of normality and automated SSS (normal = visually normal and SSS ≤ 3, abnormal = visually abnormal and SSS > 3) (A) and visual assessment of reversibility and automated SDS (no ischemia = no reversibility visually and SDS ≤ 2, ischemia = reversibility visually and SDS > 2) (B).

 


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  		FIGURE 5. Incremental contribution of automated quantitative analysis of myocardial perfusion scintigraphy to visual assessment for predicting AMI or cardiac death. Auto (dichot) = automated quantification using dichotomous measures of SSS (normal SSS ≤ 3 and abnormal SSS > 3) and SDS (normal SDS ≤ 2 and abnormal SDS > 2). Auto (cont) = automated quantification using continuous measures of SSS and SDS.

 


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  		FIGURE 6. ROC curves relating automated SSS (A) and SDS with AMI or cardiac death (B). Prespecified cutoff points on curves are indicated (arrows).

 




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