Author + information
- Roel Driessen,
- Pieter Raijmakers,
- Ibrahim Danad,
- Wijnand Stuijfzand,
- Stefan Schumacher,
- Adriaan Lammertsma,
- Albert van Rossum,
- Niels Van Royen,
- Stephen Underwood and
- Paul Knaapen
Background: Traditionally, the interpretation of myocardial perfusion imaging is based on visual analysis. A computer-based automated analysis might be a simple alternative obviating the need for extensive reading experience. Therefore, the aim of the present study is to compare the diagnostic performance of automated analysis with expert visual reading for the detection of obstructive coronary artery disease (CAD) taking invasive coronary angiography with fractional flow reserve as a reference.
Methods: 206 Patients (64% men, age 58.2 ± 8.7 years) with suspected CAD were prospectively included. All patients underwent stress-rest 99mTc-tetrofosmin single-photon emission computed tomography (SPECT), and invasive FFR measurements. Noncorrected (NC) and attenuation-corrected (AC) SPECT images were analyzed both visually by a blinded expert as well as automatically by commercially available SPECT software. Automated analysis comprised a segmental summed stress score (SSS) and the total perfusion deficit (TPD), representing the extent and severity of hypoperfused myocardium. Subsequently, software was optimized with an institutional normal database and thresholds.
Results: Visual reading sensitivity (56.5%) was slightly lower than automated analysis parameters (66.3%, 67.0%, 62.0%, 64.8%, for SSS NC, SSS AC, TPD NC, TPD AC, respectively, p > 0.05 for all). Whereas specificity was significantly higher for visual reading (93.9%) compared to automated scoring (68.4%, 71.9%, 73.7%, 76.3%, respectively, p < 0.01 for all). Diagnostic accuracy was significantly higher for visual scoring (77.2%) in comparison with NC images (67.5%, 68.4%, for SSS NC and TPD NC, respectively, p < 0.05 for both), but not compared with SSS AC and TPD AC (69.8%, 71.2%, respectively, p > 0.05). After the automated software optimization, diagnostic accuracies in the validation cohort were equal for visual (73.8%) and automated analysis: SSS NC (68.9%), SSS AC (72.5%), TPD NC (70.9%) and TPD AC (73.5%) with p > 0.100 for all.
Conclusions: Automated analysis of myocardial perfusion can be as accurate as visual interpretation by an expert reader for the detection of significant CAD defined by fractional flow reserve.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Nuclear Cardiology: Quality
Abstract Category: 30. Non Invasive Imaging: Nuclear
Presentation Number: 1246-226
- 2017 American College of Cardiology Foundation