RT Journal Article
SR Electronic
T1 Comparison of Fully Automated Computer Analysis and Visual Scoring for Detection of Coronary Artery Disease from Myocardial Perfusion SPECT in a Large Population
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 221
OP 228
DO 10.2967/jnumed.112.108969
VO 54
IS 2
A1 Reza Arsanjani
A1 Yuan Xu
A1 Sean W. Hayes
A1 Mathews Fish
A1 Mark Lemley, Jr.
A1 James Gerlach
A1 Sharmila Dorbala
A1 Daniel S. Berman
A1 Guido Germano
A1 Piotr Slomka
YR 2013
UL http://jnm.snmjournals.org/content/54/2/221.abstract
AB We compared the performance of fully automated quantification of attenuation-corrected (AC) and noncorrected (NC) myocardial perfusion SPECT (MPS) with the corresponding performance of experienced readers for detection of coronary artery disease (CAD). Methods: Rest–stress 99mTc-sestamibi MPS studies (n = 995; 650 consecutive cases with coronary angiography and 345 with likelihood of CAD < 5%) were obtained by MPS with AC. The total perfusion deficit (TPD) for AC and NC data was compared with the visual summed stress and rest scores of 2 experienced readers. Visual reads were performed in 4 consecutive steps with the following information progressively revealed: NC data, AC + NC data, computer results, and all clinical information. Results: The diagnostic accuracy of TPD for detection of CAD was similar to both readers (NC: 82% vs. 84%; AC: 86% vs. 85%–87%; P = not significant) with the exception of the second reader when clinical information was used (89%, P < 0.05). The receiver-operating-characteristic area under the curve (ROC AUC) for TPD was significantly better than visual reads for NC (0.91 vs. 0.87 and 0.89, P < 0.01) and AC (0.92 vs. 0.90, P < 0.01), and it was comparable to visual reads incorporating all clinical information. The per-vessel accuracy of TPD was superior to one reader for NC (81% vs. 77%, P < 0.05) and AC (83% vs. 78%, P < 0.05) and equivalent to the second reader (NC, 79%; and AC, 81%). The per-vessel ROC AUC for NC (0.83) and AC (0.84) for TPD was better than that for the first reader (0.78–0.80, P < 0.01) and comparable to that of the second reader (0.82–0.84, P = not significant) for all steps. Conclusion: For detection of ≥70% stenoses based on angiographic criteria, a fully automated computer analysis of NC and AC MPS data is equivalent for per-patient and can be superior for per-vessel analysis, when compared with expert analysis.