Abstract
Background
We evaluated the performance of conventional (C) single-photon emission computed tomography (SPECT) and cadmium-zinc-telluride (CZT)-SPECT in a large cohort of patients with suspected or known coronary artery disease (CAD) and compared the diagnostic accuracy of the two systems using machine learning (ML) algorithms.
Methods and Results
A total of 517 consecutive patients underwent stress myocardial perfusion imaging (MPI) by both C-SPECT and CZT-SPECT. In the overall population, an excellent correlation between stress MPI data and left ventricular (LV) functional parameters measured by C-SPECT and by CZT-SPECT was observed (all P < .001). ML analysis performed through the implementation of random forest (RF) and k-nearest neighbors (NN) algorithms proved that CZT-SPECT has greater accuracy than C-SPECT in detecting CAD. For both algorithms, the sensitivity of CZT-SPECT (96% for RF and 60% for k-NN) was greater than that of C-SPECT (88% for RF and 53% for k-NN).
Conclusions
MPI data and LV functional parameters obtained by CZT-SPECT are highly reproducible and provide good correlation with those obtained by C-SPECT. ML approach showed that the accuracy and sensitivity of CZT-SPECT is greater than C-SPECT in detecting CAD.
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Abbreviations
- SPECT:
-
Single-photon emission computed tomography
- MPI:
-
Myocardial perfusion imaging
- CAD:
-
Coronary artery disease
- C:
-
Conventional
- CZT:
-
Cadmium-zinc-telluride
- ML:
-
Machine learning
- ECG:
-
Electrocardiography
- LV:
-
Left ventricular
- EF:
-
Ejection fraction
- TPD:
-
Total perfusion defect
- SSS:
-
Summed stress score
- ICC:
-
Intraclass correlation coefficient
- RO:
-
Receiver operating characteristic
- RF:
-
Random forest
- NN:
-
Nearest neighbor
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Disclosure
V Cantoni, R. Green, C. Ricciardi, R. Assante, E. Zampella, C. Nappi, V. Gaudieri, T. Mannarino, A. Genova, G. De Simini, A. Giordano, A. D’Antonio, W. Acampa, M. Petretta, and A. Cuocolo declare that they have no conflict of interest.
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Cantoni, V., Green, R., Ricciardi, C. et al. A machine learning-based approach to directly compare the diagnostic accuracy of myocardial perfusion imaging by conventional and cadmium-zinc telluride SPECT. J. Nucl. Cardiol. 29, 46–55 (2022). https://doi.org/10.1007/s12350-020-02187-0
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DOI: https://doi.org/10.1007/s12350-020-02187-0