PT - JOURNAL ARTICLE AU - Florent Cachin AU - Janusz Lipiecki AU - Danièle Mestas AU - Aimé Amonchot AU - Benjamin Geissler AU - Cyril Thouly AU - Jean Ponsonnaille AU - Jean Maublant TI - Preliminary Evaluation of a Fuzzy Logic-Based Automatic Quantitative Analysis in Myocardial SPECT DP - 2003 Oct 01 TA - Journal of Nuclear Medicine PG - 1625--1632 VI - 44 IP - 10 4099 - http://jnm.snmjournals.org/content/44/10/1625.short 4100 - http://jnm.snmjournals.org/content/44/10/1625.full SO - J Nucl Med2003 Oct 01; 44 AB - This study validates a new quantitative myocardial perfusion SPECT software. Methods: The processing starts with the extraction of the morphologic skeleton of the left ventricular myocardium from reconstructed transverse sections. Fuzzy logic is used to decide whether a pixel belongs to the myocardium and any perfusion defect is filled according to a truncated bullet model. The resulting image is partitioned in 18 isovolumetric sectors. Sex-matched normal limits, criteria of abnormality for rest 201Tl and 99mTc-labeled perfusion tracers, reproducibility studies, and detection of coronary artery disease were developed and validated in an overall population of 343 patients. The sex- and tracer-matched means and SDs of a normal response were calculated in 93 male and 93 female patients with a <5% likelihood of coronary artery disease. Reproducibility measurements and assignment of different sectors of the myocardium to a specific coronary were performed from data collected in 49 and 60 patients, respectively. The accuracy of the detection of a coronary artery occlusion was assessed in 48 patients who also underwent coronary angiography. Results: The intra- and interoperator reproducibility of the sectorial activity was high with a linear regression coefficient of 0.97 and a SD of the difference measurement at 4.4% and 3.8%, respectively. Overall sensitivity and specificity for the detection of occluded coronary artery were 90% and 80%, respectively. For the detection of left anterior descending, left circumflex, and right artery coronary occlusion, sensitivity was 92%, 75%, and 92.5%, respectively, and specificity was 75%, 78%, and 90%, respectively. Conclusion: The new quantitative myocardial perfusion SPECT software appears to be a very helpful program for the objective analysis of perfusion tracer distribution in myocardial SPECT and a very accurate tool in the detection and localization of coronary artery occlusion.