Comparison of Fully Automated Computer Analysis and Visual Scoring for Detection of Coronary Artery Disease from Myocardial Perfusion SPECT in a Large Population
Comparison of Fully Automated Computer Analysis and Visual Scoring for Detection of Coronary Artery Disease from Myocardial Perfusion SPECT in a Large Population
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DOI：
10.2967/jnumed.112.108969
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发表时间：
2013-02-01
影响因子：
9.3
通讯作者：
Slomka, Piotr
中科院分区：
文献类型：
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作者：
Arsanjani, Reza;Xu, Yuan;Slomka, Piotr
我们比较了衰减校正（AC）和非校正（NC）心肌灌注SPECT（MPS）的全自动定量性能与经验丰富的阅片师检测冠状动脉疾病（CAD）的相应性能。研究方法：静息-负荷Tc-99 m-sestamibi MPS研究（n = 995; 650例连续冠状动脉造影病例和345例CAD可能性< 5%）通过带AC的MPS获得。将AC和NC数据的总灌注缺损（TPD）与2名经验丰富的阅片师的视觉应激和休息评分总和进行比较。在4个连续步骤中进行目视读取，逐步显示以下信息：NC数据、AC + NC数据、计算机结果和所有临床信息。结果如下：除了第二位阅片人使用临床信息时（89%，P < 0.05），两位阅片人的TPD检测CAD的诊断准确性相似（NC：82% vs. 84%; AC：86% vs. 85%-87%; P =不显著）。TPD的受试者操作特征曲线下面积（ROC AUC）显著优于NC（0.91 vs. 0.87和0.89，P < 0.01）和AC（0.92 vs. 0.90，P < 0.01）的视觉读数，并且与包含所有临床信息的视觉读数相当。对于NC（81% vs. 77%，P < 0.05）和AC（83% vs. 78%，P <0.05），TPD的每支血管准确性上级一名阅片人，与第二名阅片人相当（NC，79%; AC，81%）。对于所有步骤，TPD的NC（0.83）和AC（0.84）的每支血管ROC AUC均优于第一名阅片人（0.78-0.80，P < 0.01），与第二名阅片人相当（0.82-0.84，P =不显著）。结论：对于基于血管造影标准的>70%狭窄的检测，NC和AC MPS数据的全自动计算机分析与专家分析相比，对于每例患者而言是等效的，并且对于每支血管分析而言是上级的。
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 Tc-99m-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.