Author + information
- Michelle Wu,
- Geetha Rayarao,
- Robert Biederman and
- Mark Doyle
Background: Interpretation of non-invasive cardiac images depicting MPI, including CMR and SPECT rely on physician training and lab culture. Modalities can be characterized by a receiver operator characteristic (ROC) curve with the operating point on that curve representing a compromise between sensitivity and specificity (Sens/Spec). We hypothesize that under clinical conditions, the operating points on the ROC curve are shifted from an equalization of Sens/Spec towards higher specificity but lower sensitivity.
Methods: Modality-based studies used to evaluate myocardial ischemia and CAD were selected from peer-reviewed literature published after 2009. Studies were categorized as either 1) modalities applied in routine clinical fashion or 2) comparison of modalities under controlled conditions. The Sens/Spec was calculated for each study and plotted on an ROC graph.
Results: We evaluated data from 10 modality testing studies and 7 clinical usage studies representing >4000 pts. Average Sens/Spec values for clinical studies were 24+23/92+7% for SPECT, 31+22/ 92+6% for CTA and 17/ 93% for PET. For modality comparison studies, Sens/Spec values were 70+7/ 73+9% for SPECT, 88+10/ 90+1% for PET, 95+5/81+14% for CTA and75+27/88+9% for CMRI. The sensitivities for SPECT and CTA clinical studies were lower than modality studies (p=.07 and p <0.001, respectively).
Conclusions: Clinical studies, not modality-base studies, operate at low sensitivity and high specificity.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Insights Into Ischemic Heart Disease: Stable to Erosive Plaques
Abstract Category: 1. Acute and Stable Ischemic Heart Disease: Basic
Presentation Number: 1295-299
- 2017 American College of Cardiology Foundation