Automated Quantitative Nuclear Cardiology Methods

Motwani, Manish; Berman, Daniel S.; Germano, Guido; Slomka, Piotr J.

doi:10.1016/j.ccl.2015.08.003

Cited by 15 publications

(4 citation statements)

References 54 publications

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“…The SRS indicates the degree of ischemia and infarct ( 32 ) and is often correlated with fixed ischemia. Previously, cardiologists and nuclear physicians mainly relied on SRS, TPD, and gated parameters to analyze the severity of myocardial infarction, prognostic information, and treatment decisions ( 9 – 12 ).…”

Section: Discussionmentioning

confidence: 99%

The diagnostic role of resting myocardial blood flow in STEMI patients after revascularization

Yan,

Shang,

Guo

et al. 2024

Front. Cardiovasc. Med.

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BackgroundThe value of semiquantitative resting myocardial perfusion imaging (MPI) in coronary artery disease (CAD) is limited. At present, quantitative MPI can be performed by a new cadmium zinc tellurium single-photon emission computed tomography (CZT-SPECT) scan. The quantitative index of resting myocardial blood flow (MBF) has received little attention, and its manifestations and clinical value in the presence of unstable coronary blood flow have not been clarified.PurposeIn patients with ST-segment elevation myocardial infarction (STEMI), whether resting MBF can provide additional value of blood flow than semi-quantitative resting MPI is not sure. We also explored the influencing factors of resting MBF.MethodsThis was a retrospective clinical study. We included 75 patients with STEMI in the subacute phase who underwent resting MPI and dynamic scans after reperfusion therapy. General patient information, STEMI-related data, MPI, gated MPI (G-MPI), and resting MBF data were collected and recorded. According to the clinically provided culprit vessels, the resting MBF was divided into ischemic MBF and non-ischemic MBF. The paired Wilcoxon signed-rank test was used for resting MBF. The receiver operating characteristic (ROC) curves were used to determine the optimal threshold for ischemia, and multiple linear regression analysis was used to analyze the influencing factors of resting MBF.ResultsThere was a statistically significant difference between the ischemic MBF and non-ischemic MBF [0.59 (0.47–0.72) vs. 0.76 (0.64–0.93), p < 0.0001]. The ROC curve analysis revealed that resting MBF could identify ischemia to a certain extent, with a cutoff value of 0.5975, area under the curve (AUC) = 0.666, sensitivity = 55.8%, and specificity = 68.7%. Male sex and summed rest score (SRS) were influencing factors for resting MBF.ConclusionTo a certain extent, resting MBF can suggest residual ischemia after reperfusion therapy in patients with STEMI. There was a negative correlation between male sex, SRS, and ischemic MBF. A lower resting MBF may be associated with more severe myocardial ischemia.

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Section: Discussionmentioning

confidence: 99%

The diagnostic role of resting myocardial blood flow in STEMI patients after revascularization

Yan,

Shang,

Guo

et al. 2024

Front. Cardiovasc. Med.

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“…The adjunctive role of automated analyses in nuclear cardiology practice is at least partially associated with a main drawback of software packages, which cannot explicitly differentiate between real perfusion abnormalities and artefacts [ 8 ]. In addition, although the performance of the software packages has been demonstrated to be similar, certain differences in the magnitudes of the derived values have been reported [ 18 ]. In particular, comparing the diagnostic performance of three software packages (ECTb, QPS, and 4DMSPECT), Wolak et al reported differences in myocardial perfusion quantification, while Knollmann et al found differences in measurements (derived from QPS and 4DMSPECT), using either manufacturer’s or institutional normal databases [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Automated Analysis vs. Expert Reading in Nuclear Cardiology: Correlations with the Angiographic Score

et al. 2022

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Background and Objectives: Myocardial perfusion imaging (MPI) has an important role in the non-invasive investigation of coronary artery disease. The interpretation of MPI studies is mainly based on the visual evaluation of the reconstructed images, while automated quantitation methods may add useful data for each patient. However, little evidence is currently available regarding the actual incremental clinical diagnostic performance of automated MPI analysis. In the present study, we aimed to assess the correlation between automated measurements of Summed Stress Score (SSS), Summed Rest Score (SRS) and Summed Difference Score (SDS), with the corresponding expert reading values, using coronary angiography as the gold standard. Materials and Methods: The study was conducted at the Nuclear Medicine Laboratory of the University Hospital of Larissa, Larissa, Greece, οver an one-year period (January 2019–January 2020). 306 patients, with known or suspected coronary artery disease, were enrolled in the study. Each participant underwent a coronary angiography, prior to or after the scintigraphic study (within a three-month period). Either symptom-limited treadmill test, or pharmacologic testing using adenosine or regadenoson, was performed in all participants, and the scintigraphic studies were carried out using technetium 99m (99mTc) tetrofosmin (one-day stress/rest protocol). Coronary angiographies were scored according to a 4-point scoring system (angiographic score; O: normal study, 1: one-vessel disease, 2: two-vessel disease, 3: three-vessel disease). Moreover, automated measurements of SSS, SRS and SDS were derived by three widely available software packages (Emory Cardiac Toolbox, Myovation, Quantitative Perfusion SPECT). Results: Interclass Correlation Coefficients of SSS, SRS and SDS between expert reading and software packages were moderate to excellent. Visually defined SSS, SRS and SDS were significantly correlated with the corresponding results of all software packages. However, visually defined SSS, SRS and SDS were more strongly correlated with the angiographic score, indicating a better performance of expert reading when compared to automated analysis. Conclusions: Based on our results, visual evaluation continues to have a crucial role for the interpretation of MPI images. Software packages can provide automated measurements of several parameters, particularly contributing to the investigation of cases with ambiguous scintigraphic findings.

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“…It is also known that LVEF and left ventricular volumes are important prognostic factors in patients with CAD and left ventricular dysfunction. There is a strong correlation between gated MPI and reference standard measurements of quantitative LVEF, all of which are relatively independent of the isotope, protocol, standard, and algorithm used (14). In a similar manner, TID measured by all the algorithms notwithstanding with effort type is a specific indicator of severe and extensive coronary disease, and TID with positive MPS is accepted as a predictor of poor clinical outcome (15,16).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Myocardial Perfusion Imaging SPECT Parameters and Pharmacologic Stress Test with Adenosine Versus Coronary Angiography Findings: Are They Diagnostically Concordant?

Hasbek¹,

Ertürk²,

Çakmakçılar³

et al. 2019

Mirt

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Objectives: In this study our first aim was to evaluate the diagnostic concordance of myocardial perfusion scintigraphy (MPS) by pharmacological stress test with adenosine (APST) with coronary angiography (CAG). The secondary aim of this study was to evaluate the correlation between CAG findings and automated analysis parameters such as left ventricular ejection fraction, summed stress score (SSS), summed rest score, summed difference score (SDS), stress MPS defect percentage ratio (extent) and transient ischemic dilation (TID) obtained by myocardial perfusion imaging single-photon emission computed tomography (SPECT). Methods: A total of 129 patients (62 male, 67 female, median age: 60.02) undergoing MPS due to suspicion of coronary ischemia who also underwent subsequent CAG in the last year were included in this study, their MPS data and CAG results were compared. Results: There was no statistically significant diagnostic concordance when visual evaluation of MPS, quantitative MPS parameters and exercise treadmill test (ETT) electrocardiography results were used alone. In fact, diagnostic concordance was higher when automated analysis parameters like TID, SSS and extent values were added to MPS SPECT visual analyses. There was diagnostic concordance in 57.9% of APST patients and 41.7% of ETT patients. There was diagnostic concordance in 75.8% of APST patients and 52.6% of ETT patients who were older than 65 years of age. Conclusion: In our study, we found that the use of APST during MPS increases diagnostic concordance with CAG. Therefore, we think that it would be appropriate to use APST in women and elderly patients with limited exercise habits. The CAG diagnostic mismatch is far above what it should be when MPS reporting is only done with visual data, and it is not supported by quantitative data such as TID, SSS, SDS and extent.

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Automated Quantitative Nuclear Cardiology Methods

Cited by 15 publications

References 54 publications

The diagnostic role of resting myocardial blood flow in STEMI patients after revascularization

The diagnostic role of resting myocardial blood flow in STEMI patients after revascularization

Automated Analysis vs. Expert Reading in Nuclear Cardiology: Correlations with the Angiographic Score

Evaluation of Myocardial Perfusion Imaging SPECT Parameters and Pharmacologic Stress Test with Adenosine Versus Coronary Angiography Findings: Are They Diagnostically Concordant?

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