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Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 11/2010

01.11.2010 | Original Article

Comparison of diagnostic performances of three different software packages in detecting coronary artery disease

verfasst von: Levent A. Guner, Nese Ilgin Karabacak, Tansel Cakir, Ozgur U. Akdemir, Sinan A. Kocaman, Atiye Cengel, Mustafa Unlu

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 11/2010

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Abstract

Purpose

Quantification of myocardial perfusion scintigraphy is frequently performed to assist physicians in detecting coronary artery disease (CAD). Software packages provide automated quantification of perfusion data. We aimed to compare the three commonly used software packages, Emory Cardiac Toolbox (ECT v2 and ECT v3), 4D-MSPECT (4DM v2 and 4DM v4) and Quantitative Perfusion SPECT (QPS v3 and QPS v4).

Methods

We selected 283 patients who had a myocardial perfusion scintigraphy with 201Tl followed by coronary angiography within 3 months. Summed stress score (SSS), summed difference score (SDS), total stress defect extent (TDE) and regional stress defect extent values were obtained from programs. A ≥70% stenosis in coronary arteries and their major branches was considered positive for CAD. A subgroup of patients was used to form an institutional normal database for QPS and 4DM. Receiver-operating characteristic (ROC) analysis to detect CAD was performed.

Results

Mean SSS ± SD (vendor) for ECT v3, QPS v4 and 4DM v4 were 9.2 ± 7.1, 10.1 ± 6.8 and 5.5 ± 6.1, respectively. Area under the curve (AUC) values of SSS ROC analysis were 0.738 ± 0.031 for QPS v3, 0.755 ± 0.030 for QPS v4, 0.758 ± 0.030 for ECT v2, 0.778 ± 0.029 for ECT v3 and 0.771 ± 0.030 for 4DM v4. The AUC values for TDE were 0.755 ± 0.030 for QPS v4, 0.769 ± 0.030 for ECT v3 and 0.775 ± 0.029 for 4DM v4. The differences were not significant for both SSS and TDE. Differences of AUC between regional stress defect extent values of programs and AUC of SSS between institutional and vendor normal databases were not significant.

Conclusion

The diagnostic performances of programs to detect CAD are similar. However, there are differences in the magnitudes of the quantitative values produced by the programs.
Literatur
1.
Zurück zum Zitat Rochmis P, Blackburn H. Exercise tests. A survey of procedures, safety, and litigation experience in approximately 170,000 tests. JAMA 1971;217:1061–6.CrossRefPubMed Rochmis P, Blackburn H. Exercise tests. A survey of procedures, safety, and litigation experience in approximately 170,000 tests. JAMA 1971;217:1061–6.CrossRefPubMed
2.
Zurück zum Zitat Cerqueira MD, Verani MS, Schwaiger M, Heo J, Iskandrian AS. Safety profile of adenosine stress perfusion imaging: results from the Adenoscan Multicenter Trial Registry. J Am Coll Cardiol 1994;23:384–9.CrossRefPubMed Cerqueira MD, Verani MS, Schwaiger M, Heo J, Iskandrian AS. Safety profile of adenosine stress perfusion imaging: results from the Adenoscan Multicenter Trial Registry. J Am Coll Cardiol 1994;23:384–9.CrossRefPubMed
3.
Zurück zum Zitat Abreu A, Mahmarian JJ, Nishimura S, Boyce TM, Verani MS. Tolerance and safety of pharmacologic coronary vasodilation with adenosine in association with thallium-201 scintigraphy in patients with suspected coronary artery disease. J Am Coll Cardiol 1991;18:730–5.CrossRefPubMed Abreu A, Mahmarian JJ, Nishimura S, Boyce TM, Verani MS. Tolerance and safety of pharmacologic coronary vasodilation with adenosine in association with thallium-201 scintigraphy in patients with suspected coronary artery disease. J Am Coll Cardiol 1991;18:730–5.CrossRefPubMed
4.
Zurück zum Zitat Lette J, Tatum JL, Fraser S, Miller DD, Waters DD, Heller G, et al. Safety of dipyridamole testing in 73,806 patients: the Multicenter Dipyridamole Safety Study. J Nucl Cardiol 1995;2:3–17.CrossRefPubMed Lette J, Tatum JL, Fraser S, Miller DD, Waters DD, Heller G, et al. Safety of dipyridamole testing in 73,806 patients: the Multicenter Dipyridamole Safety Study. J Nucl Cardiol 1995;2:3–17.CrossRefPubMed
5.
Zurück zum Zitat Mertes H, Sawada SG, Ryan T, Segar DS, Kovacs R, Foltz J, et al. Symptoms, adverse effects, and complications associated with dobutamine stress echocardiography. Experience in 1118 patients. Circulation 1993;88:15–9.PubMed Mertes H, Sawada SG, Ryan T, Segar DS, Kovacs R, Foltz J, et al. Symptoms, adverse effects, and complications associated with dobutamine stress echocardiography. Experience in 1118 patients. Circulation 1993;88:15–9.PubMed
6.
Zurück zum Zitat Candell-Riera J, Santana-Boado C, Bermejo B, Armadans L, Castell J, Casáns I, et al. Interhospital observer agreement in interpretation of exercise myocardial Tc-99m tetrofosmin SPECT studies. J Nucl Cardiol 2001;8:49–57. doi:10.1067/mnc.2001.110388.CrossRefPubMed Candell-Riera J, Santana-Boado C, Bermejo B, Armadans L, Castell J, Casáns I, et al. Interhospital observer agreement in interpretation of exercise myocardial Tc-99m tetrofosmin SPECT studies. J Nucl Cardiol 2001;8:49–57. doi:10.​1067/​mnc.​2001.​110388.CrossRefPubMed
7.
Zurück zum Zitat Brambilla M, Inglese E, Cannizzaro G, Dondi M, Sara R, Arrigo F, et al. A multicenter trial on interobserver and intraobserver reproducibility of segmental scoring of thallium-201 planar myocardial imaging before and after reinjection. Italian Group of Nuclear Cardiology. J Nucl Med 1994;35:601–8.PubMed Brambilla M, Inglese E, Cannizzaro G, Dondi M, Sara R, Arrigo F, et al. A multicenter trial on interobserver and intraobserver reproducibility of segmental scoring of thallium-201 planar myocardial imaging before and after reinjection. Italian Group of Nuclear Cardiology. J Nucl Med 1994;35:601–8.PubMed
9.
Zurück zum Zitat Germano G, Kavanagh PB, Slomka PJ, Van Kriekinge SD, Pollard G, Berman DS. Quantitation in gated perfusion SPECT imaging: the Cedars-Sinai approach. J Nucl Cardiol 2007;14:433–54.CrossRefPubMed Germano G, Kavanagh PB, Slomka PJ, Van Kriekinge SD, Pollard G, Berman DS. Quantitation in gated perfusion SPECT imaging: the Cedars-Sinai approach. J Nucl Cardiol 2007;14:433–54.CrossRefPubMed
11.
Zurück zum Zitat Verberne HJ, Habraken JB, van Royen EA, Tiel-van Buul MM, Piek JJ, van Eck-Smit BL. Quantitative analysis of 99Tcm-sestamibi myocardial perfusion SPECT using a three-dimensional reference heart: a comparison with experienced observers. Nucl Med Commun 2001;22:155–63.CrossRefPubMed Verberne HJ, Habraken JB, van Royen EA, Tiel-van Buul MM, Piek JJ, van Eck-Smit BL. Quantitative analysis of 99Tcm-sestamibi myocardial perfusion SPECT using a three-dimensional reference heart: a comparison with experienced observers. Nucl Med Commun 2001;22:155–63.CrossRefPubMed
12.
Zurück zum Zitat Wolak A, Slomka PJ, Fish MB, Lorenzo S, Acampa W, Berman DS, et al. Quantitative myocardial-perfusion SPECT: comparison of three state-of-the-art software packages. J Nucl Cardiol 2008;15:27–34.CrossRefPubMed Wolak A, Slomka PJ, Fish MB, Lorenzo S, Acampa W, Berman DS, et al. Quantitative myocardial-perfusion SPECT: comparison of three state-of-the-art software packages. J Nucl Cardiol 2008;15:27–34.CrossRefPubMed
13.
Zurück zum Zitat Svensson A, Akesson L, Edenbrandt L. Quantification of myocardial perfusion defects using three different software packages. Eur J Nucl Med Mol Imaging 2004;31:229–32.CrossRefPubMed Svensson A, Akesson L, Edenbrandt L. Quantification of myocardial perfusion defects using three different software packages. Eur J Nucl Med Mol Imaging 2004;31:229–32.CrossRefPubMed
14.
Zurück zum Zitat Knollmann D, Knebel I, Koch KC, Gebhard M, Krohn T, Buell U, et al. Comparison of SSS and SRS calculated from normal databases provided by QPS and 4D-MSPECT manufacturers and from identical institutional normals. Eur J Nucl Med Mol Imaging 2008;35:311–8.CrossRefPubMed Knollmann D, Knebel I, Koch KC, Gebhard M, Krohn T, Buell U, et al. Comparison of SSS and SRS calculated from normal databases provided by QPS and 4D-MSPECT manufacturers and from identical institutional normals. Eur J Nucl Med Mol Imaging 2008;35:311–8.CrossRefPubMed
15.
Zurück zum Zitat Hanley JA, McNeil BJ. A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 1983;148:839–43.PubMed Hanley JA, McNeil BJ. A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 1983;148:839–43.PubMed
16.
Zurück zum Zitat Marcassa C, Bax JJ, Bengel F, Hesse B, Petersen CL, Reyes E, et al. Clinical value, cost-effectiveness, and safety of myocardial perfusion scintigraphy: a position statement. Eur Heart J 2008;29:557–63. doi:10.1093/eurheartj/ehm607.CrossRefPubMed Marcassa C, Bax JJ, Bengel F, Hesse B, Petersen CL, Reyes E, et al. Clinical value, cost-effectiveness, and safety of myocardial perfusion scintigraphy: a position statement. Eur Heart J 2008;29:557–63. doi:10.​1093/​eurheartj/​ehm607.CrossRefPubMed
17.
Zurück zum Zitat Nishimura T, Nakajima K, Kusuoka H, Yamashina A, Nishimura S. Prognostic study of risk stratification among Japanese patients with ischemic heart disease using gated myocardial perfusion SPECT: J-ACCESS study. Eur J Nucl Med Mol Imaging 2008;35:319–28.CrossRefPubMed Nishimura T, Nakajima K, Kusuoka H, Yamashina A, Nishimura S. Prognostic study of risk stratification among Japanese patients with ischemic heart disease using gated myocardial perfusion SPECT: J-ACCESS study. Eur J Nucl Med Mol Imaging 2008;35:319–28.CrossRefPubMed
18.
Zurück zum Zitat Hachamovitch R, Berman DS, Kiat H, Cohen I, Cabico JA, Friedman J, et al. Exercise myocardial perfusion SPECT in patients without known coronary artery disease: incremental prognostic value and use in risk stratification. Circulation 1996;93:905–14.PubMed Hachamovitch R, Berman DS, Kiat H, Cohen I, Cabico JA, Friedman J, et al. Exercise myocardial perfusion SPECT in patients without known coronary artery disease: incremental prognostic value and use in risk stratification. Circulation 1996;93:905–14.PubMed
19.
Zurück zum Zitat Hachamovitch R, Hayes SW, Friedman JD, Cohen I, Berman DS. Stress myocardial perfusion single-photon emission computed tomography is clinically effective and cost effective in risk stratification of patients with a high likelihood of coronary artery disease (CAD) but no known CAD. J Am Coll Cardiol 2004;43:200–8. doi:S0735109703014268.CrossRefPubMed Hachamovitch R, Hayes SW, Friedman JD, Cohen I, Berman DS. Stress myocardial perfusion single-photon emission computed tomography is clinically effective and cost effective in risk stratification of patients with a high likelihood of coronary artery disease (CAD) but no known CAD. J Am Coll Cardiol 2004;43:200–8. doi:S073510970301426​8.CrossRefPubMed
20.
Zurück zum Zitat Nakajima K, Okuda K, Kawano M, Matsuo S, Slomka P, Germano G, et al. The importance of population-specific normal database for quantification of myocardial ischemia: comparison between Japanese 360 and 180-degree databases and a US database. J Nucl Cardiol 2009;16:422–30.CrossRefPubMed Nakajima K, Okuda K, Kawano M, Matsuo S, Slomka P, Germano G, et al. The importance of population-specific normal database for quantification of myocardial ischemia: comparison between Japanese 360 and 180-degree databases and a US database. J Nucl Cardiol 2009;16:422–30.CrossRefPubMed
21.
Zurück zum Zitat White CW, Wright CB, Doty DB, Hiratza LF, Eastham CL, Harrison DG, et al. Does visual interpretation of the coronary arteriogram predict the physiologic importance of a coronary stenosis? N Engl J Med 1984;310:819–24.CrossRefPubMed White CW, Wright CB, Doty DB, Hiratza LF, Eastham CL, Harrison DG, et al. Does visual interpretation of the coronary arteriogram predict the physiologic importance of a coronary stenosis? N Engl J Med 1984;310:819–24.CrossRefPubMed
22.
Zurück zum Zitat Toft J, Lindahl D, Ohlsson M, Palmer J, Lundin A, Edenbrandt L, et al. The optimal reference population for cardiac normality in myocardial SPET in the detection of coronary artery stenoses: patients with normal coronary angiography or subjects with low likelihood of coronary artery disease? Eur J Nucl Med 2001;28:831–5.CrossRefPubMed Toft J, Lindahl D, Ohlsson M, Palmer J, Lundin A, Edenbrandt L, et al. The optimal reference population for cardiac normality in myocardial SPET in the detection of coronary artery stenoses: patients with normal coronary angiography or subjects with low likelihood of coronary artery disease? Eur J Nucl Med 2001;28:831–5.CrossRefPubMed
23.
Zurück zum Zitat Slomka PJ, Nishina H, Berman DS, Kang X, Friedman JD, Hayes SW, et al. Automatic quantification of myocardial perfusion stress-rest change: a new measure of ischemia. J Nucl Med 2004;45:183–91.PubMed Slomka PJ, Nishina H, Berman DS, Kang X, Friedman JD, Hayes SW, et al. Automatic quantification of myocardial perfusion stress-rest change: a new measure of ischemia. J Nucl Med 2004;45:183–91.PubMed
Metadaten
Titel
Comparison of diagnostic performances of three different software packages in detecting coronary artery disease
verfasst von
Levent A. Guner
Nese Ilgin Karabacak
Tansel Cakir
Ozgur U. Akdemir
Sinan A. Kocaman
Atiye Cengel
Mustafa Unlu
Publikationsdatum
01.11.2010
Verlag
Springer-Verlag
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 11/2010
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-010-1522-1

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