Area of ischemia assessed by physicians and software packages from myocardial perfusion scintigrams

Abstract

BackgroundThe European Society of Cardiology recommends that patients with >10% area of ischemia should receive revascularization. We investigated inter-observer variability for the extent of ischemic defects reported by different physicians and by different software tools, and if inter-observer variability was reduced when the physicians were provided with a computerized suggestion of the defects.MethodsTwenty-five myocardial perfusion single photon emission computed tomography (SPECT) patients who were regarded as ischemic according to the final report were included. Eleven physicians in nuclear medicine delineated the extent of the ischemic defects. After at least two weeks, they delineated the defects again, and were this time provided a suggestion of the defect delineation by EXINI HeartTM (EXINI). Summed difference scores and ischemic extent values were obtained from four software programs.ResultsThe median extent values obtained from the 11 physicians varied between 8% and 34%, and between 9% and 16% for the software programs. For all 25 patients, mean extent obtained from EXINI was 17.0% (± standard deviation (SD) 14.6%). Mean extent for physicians was 22.6% (± 15.6%) for the first delineation and 19.1% (± 14.9%) for the evaluation where they were provided computerized suggestion. Intra-class correlation (ICC) increased from 0.56 (95% confidence interval (CI) 0.41-0.72) to 0.81 (95% CI 0.71-0.90) between the first and the second delineation, and SD between physicians were 7.8 (first) and 5.9 (second delineation).ConclusionsThere was large variability in the estimated ischemic defect size obtained both from different physicians and from different software packages. When the physicians were provided with a suggested delineation, the inter-observer variability decreased significantly.

Artificial neural network retrained to detect myocardial ischemia using a Japanese multicenter database

“…However, diagnostic relevance should be further investigated since such approaches are not common to medical diagnostics. Since estimated areas of ischemia vary widely among physicians, the presence of defects and ischemia suggested by appropriate software packages would help to reduce the inter-observer variability of clinical interpretations [ 17 ].…”

Diagnostic Performance of Artificial Neural Network for Detecting Ischemia in Myocardial Perfusion Imaging

“…By using the computer guide, variations of the interpretation became significantly smaller. 22 Highquality diagnostic suggestions for the existence of abnormality provided by computer software would be beneficial as a reference in standardizing image interpretation. Although the diagnostic value of the scoring system have been validated in a number of studies, the scoring ability may differ among commercially available software packages and cannot be used interchangeably even if the detectability of CAD is comparable.…”

Cardiac and Respiratory Motion-induced Artifact in Myocardial Perfusion SPECT

“…The anterior, inferior, and anterolateral myocardial counts were calculated as mean values in the segments 1 and 7, segments 4 and 10, and segments 12 and 16 on American Heart Association classification of the polar map (10), respectively. We used cardioREPO (cREPO; FUJIFILM RI Pharma, Tokyo, Japan) software program integrated with an artificial neural network (ANN) feature for evaluation of myocardial perfusion and compensation of small-heart effect (11)(12)(13)(14). This software program automatically creates diagnosis based on the probability of perfusion abnormality using ANN trained by expert nuclear medicine physicians and cardiologists.…”