Automated quantification of myocardial perfusion SPECT using simplified normal limits

Piotr J. Slomka, Hidetaka Nishina, Daniel S. Berman, Cigdem Akincioglu, Aiden Abidov, John D. Friedman, Sean W. Hayes, Guido Germano

Research output: Contribution to journalArticle

170 Citations (Scopus)

Abstract

Background. To simplify development of normal limits for myocardial perfusion SPECT (MPS), we implemented a quantification scheme in which normal limits are derived without visual scoring of abnormal scans or optimization of regional thresholds. Methods and results. Normal limits were derived from same-day TI-201 rest/Tc-99m-sestamibi stress scans of male (n = 40) and female (n = 40) low-likelihood patients. Defect extent, total perfusion deficit (TPD), and regional perfusion extents were derived by comparison to normal limits in polar-map coordinates. MPS scans from 256 consecutive patients without known coronary artery disease, who underwent coronary angiography, were analyzed. The new method of quantification (TPD) was compared with our previously developed quantification system and visual scoring. The receiver operator characteristic area under the curve for detection of 50% or greater stenoses by TPD (0.88 ± 0.02) was higher than by visual scoring (0.83 ± 0.03) (P = .039) or standard quantification (0.82 ± 0.03) (P = .004). For detection of 70% or greater stenoses, it was higher for TPD (0.89 ± 0.02) than for standard quantification (0.85 ± 0.02) (P = .014). Sensitivity and specificity were 93% and 79%, respectively, for TPD; 81% and 85%, respectively, for visual scoring; and 80% and 73%, respectively, for standard quantification. The use of stress mode-specific normal limits did not improve performance. Conclusion. Simplified quantification achieves performance better than or equivalent to visual scoring or quantification based on per-segment visual optimization of abnormality thresholds.

Original languageEnglish (US)
Pages (from-to)66-77
Number of pages12
JournalJournal of Nuclear Cardiology
Volume12
Issue number1
DOIs
StatePublished - Jan 2005
Externally publishedYes

Fingerprint

Single-Photon Emission-Computed Tomography
Perfusion
Pathologic Constriction
Coronary Angiography
Area Under Curve
Coronary Artery Disease
Sensitivity and Specificity

Keywords

  • Myocardial perfusion single photon emission computed tomography
  • Total perfusion deficit
  • Visual scoring

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Slomka, P. J., Nishina, H., Berman, D. S., Akincioglu, C., Abidov, A., Friedman, J. D., ... Germano, G. (2005). Automated quantification of myocardial perfusion SPECT using simplified normal limits. Journal of Nuclear Cardiology, 12(1), 66-77. https://doi.org/10.1016/j.nuclcard.2004.10.006

Automated quantification of myocardial perfusion SPECT using simplified normal limits. / Slomka, Piotr J.; Nishina, Hidetaka; Berman, Daniel S.; Akincioglu, Cigdem; Abidov, Aiden; Friedman, John D.; Hayes, Sean W.; Germano, Guido.

In: Journal of Nuclear Cardiology, Vol. 12, No. 1, 01.2005, p. 66-77.

Research output: Contribution to journalArticle

Slomka, PJ, Nishina, H, Berman, DS, Akincioglu, C, Abidov, A, Friedman, JD, Hayes, SW & Germano, G 2005, 'Automated quantification of myocardial perfusion SPECT using simplified normal limits', Journal of Nuclear Cardiology, vol. 12, no. 1, pp. 66-77. https://doi.org/10.1016/j.nuclcard.2004.10.006
Slomka, Piotr J. ; Nishina, Hidetaka ; Berman, Daniel S. ; Akincioglu, Cigdem ; Abidov, Aiden ; Friedman, John D. ; Hayes, Sean W. ; Germano, Guido. / Automated quantification of myocardial perfusion SPECT using simplified normal limits. In: Journal of Nuclear Cardiology. 2005 ; Vol. 12, No. 1. pp. 66-77.
@article{b09cc6d088f640b89e485799098c8e47,
title = "Automated quantification of myocardial perfusion SPECT using simplified normal limits",
abstract = "Background. To simplify development of normal limits for myocardial perfusion SPECT (MPS), we implemented a quantification scheme in which normal limits are derived without visual scoring of abnormal scans or optimization of regional thresholds. Methods and results. Normal limits were derived from same-day TI-201 rest/Tc-99m-sestamibi stress scans of male (n = 40) and female (n = 40) low-likelihood patients. Defect extent, total perfusion deficit (TPD), and regional perfusion extents were derived by comparison to normal limits in polar-map coordinates. MPS scans from 256 consecutive patients without known coronary artery disease, who underwent coronary angiography, were analyzed. The new method of quantification (TPD) was compared with our previously developed quantification system and visual scoring. The receiver operator characteristic area under the curve for detection of 50{\%} or greater stenoses by TPD (0.88 ± 0.02) was higher than by visual scoring (0.83 ± 0.03) (P = .039) or standard quantification (0.82 ± 0.03) (P = .004). For detection of 70{\%} or greater stenoses, it was higher for TPD (0.89 ± 0.02) than for standard quantification (0.85 ± 0.02) (P = .014). Sensitivity and specificity were 93{\%} and 79{\%}, respectively, for TPD; 81{\%} and 85{\%}, respectively, for visual scoring; and 80{\%} and 73{\%}, respectively, for standard quantification. The use of stress mode-specific normal limits did not improve performance. Conclusion. Simplified quantification achieves performance better than or equivalent to visual scoring or quantification based on per-segment visual optimization of abnormality thresholds.",
keywords = "Myocardial perfusion single photon emission computed tomography, Total perfusion deficit, Visual scoring",
author = "Slomka, {Piotr J.} and Hidetaka Nishina and Berman, {Daniel S.} and Cigdem Akincioglu and Aiden Abidov and Friedman, {John D.} and Hayes, {Sean W.} and Guido Germano",
year = "2005",
month = "1",
doi = "10.1016/j.nuclcard.2004.10.006",
language = "English (US)",
volume = "12",
pages = "66--77",
journal = "Journal of Nuclear Cardiology",
issn = "1071-3581",
publisher = "Springer New York",
number = "1",

}

TY - JOUR

T1 - Automated quantification of myocardial perfusion SPECT using simplified normal limits

AU - Slomka, Piotr J.

AU - Nishina, Hidetaka

AU - Berman, Daniel S.

AU - Akincioglu, Cigdem

AU - Abidov, Aiden

AU - Friedman, John D.

AU - Hayes, Sean W.

AU - Germano, Guido

PY - 2005/1

Y1 - 2005/1

N2 - Background. To simplify development of normal limits for myocardial perfusion SPECT (MPS), we implemented a quantification scheme in which normal limits are derived without visual scoring of abnormal scans or optimization of regional thresholds. Methods and results. Normal limits were derived from same-day TI-201 rest/Tc-99m-sestamibi stress scans of male (n = 40) and female (n = 40) low-likelihood patients. Defect extent, total perfusion deficit (TPD), and regional perfusion extents were derived by comparison to normal limits in polar-map coordinates. MPS scans from 256 consecutive patients without known coronary artery disease, who underwent coronary angiography, were analyzed. The new method of quantification (TPD) was compared with our previously developed quantification system and visual scoring. The receiver operator characteristic area under the curve for detection of 50% or greater stenoses by TPD (0.88 ± 0.02) was higher than by visual scoring (0.83 ± 0.03) (P = .039) or standard quantification (0.82 ± 0.03) (P = .004). For detection of 70% or greater stenoses, it was higher for TPD (0.89 ± 0.02) than for standard quantification (0.85 ± 0.02) (P = .014). Sensitivity and specificity were 93% and 79%, respectively, for TPD; 81% and 85%, respectively, for visual scoring; and 80% and 73%, respectively, for standard quantification. The use of stress mode-specific normal limits did not improve performance. Conclusion. Simplified quantification achieves performance better than or equivalent to visual scoring or quantification based on per-segment visual optimization of abnormality thresholds.

AB - Background. To simplify development of normal limits for myocardial perfusion SPECT (MPS), we implemented a quantification scheme in which normal limits are derived without visual scoring of abnormal scans or optimization of regional thresholds. Methods and results. Normal limits were derived from same-day TI-201 rest/Tc-99m-sestamibi stress scans of male (n = 40) and female (n = 40) low-likelihood patients. Defect extent, total perfusion deficit (TPD), and regional perfusion extents were derived by comparison to normal limits in polar-map coordinates. MPS scans from 256 consecutive patients without known coronary artery disease, who underwent coronary angiography, were analyzed. The new method of quantification (TPD) was compared with our previously developed quantification system and visual scoring. The receiver operator characteristic area under the curve for detection of 50% or greater stenoses by TPD (0.88 ± 0.02) was higher than by visual scoring (0.83 ± 0.03) (P = .039) or standard quantification (0.82 ± 0.03) (P = .004). For detection of 70% or greater stenoses, it was higher for TPD (0.89 ± 0.02) than for standard quantification (0.85 ± 0.02) (P = .014). Sensitivity and specificity were 93% and 79%, respectively, for TPD; 81% and 85%, respectively, for visual scoring; and 80% and 73%, respectively, for standard quantification. The use of stress mode-specific normal limits did not improve performance. Conclusion. Simplified quantification achieves performance better than or equivalent to visual scoring or quantification based on per-segment visual optimization of abnormality thresholds.

KW - Myocardial perfusion single photon emission computed tomography

KW - Total perfusion deficit

KW - Visual scoring

UR - http://www.scopus.com/inward/record.url?scp=12744255408&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=12744255408&partnerID=8YFLogxK

U2 - 10.1016/j.nuclcard.2004.10.006

DO - 10.1016/j.nuclcard.2004.10.006

M3 - Article

C2 - 15682367

AN - SCOPUS:12744255408

VL - 12

SP - 66

EP - 77

JO - Journal of Nuclear Cardiology

JF - Journal of Nuclear Cardiology

SN - 1071-3581

IS - 1

ER -