Journal of Nuclear Cardiology

, Volume 15, Issue 1, pp 27–34 | Cite as

Quantitative myocardial-perfusion SPECT: Comparison of three state-of-the-art software packages

  • Arik Wolak
  • Piotr J. Slomka
  • Mathews B. Fish
  • Santiago Lorenzo
  • Wanda Acampa
  • Daniel S. Berman
  • Guido Germano
Original Articles



We almed to compare the automation and diagnostic performance in the detection of coronary artery disease (CAD) of the 4DMSPECT (4DM), Emory Cardiac Toolbox (EMO), and QPS systems for automated quantification of myocardial perfusion.

Methods and Results

We studied 328 patients referred for rest/stress Tc-99m sestamibi imaging, 140 low-likelihood patients and 188 with angiography. Contours were corrected when necessary. All other processing was fully automated. A 17-segment analysis was performed, and a summed stress score (SSS) ≥4 was considered abnormal. The average SSSs (±SD) for 4DM, EMO, and QPS were 10.5±9.4, 11.1±8.3, and 10.1±8.9 respectively (P=.02 for QPS versus EMO). The receiver operator characteristics areas-under-the-curve for the detection of CAD (±SEM) were 0.84±0.03, 0.76±0.04, and 0.88±0.03 for 4DM, EMO, and QPS, respectively (P=.001 for QPS versus EMO, and P=.03 for 4DM versus EMO), Normalcy rate was higher for QPS and 4DM versus EMO, at 91% and 94% versus 77%, respectively (P=.02). Sensitivity was higher for QPS (87%) versus 4DM (80%) (P=.045). Specificity was higher for QPS (71%) versus EMO (49%) (P=.01). The accuracy rate was higher for QPS versus 4DM and EMO, at 83% versus 77% and 76%, respectively, (P=.05).


There are differences in myocardial-perfusion quantification, diagnostic performance, and degree of automation of software packages.

Key Words

Myocardial perfusion imaging SPECT automatic quantification software coronary artery disease 


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Copyright information

© American Society of Nuclear Cardiology 2008

Authors and Affiliations

  • Arik Wolak
    • 1
  • Piotr J. Slomka
    • 2
  • Mathews B. Fish
    • 3
  • Santiago Lorenzo
    • 4
  • Wanda Acampa
    • 1
  • Daniel S. Berman
    • 1
  • Guido Germano
    • 2
  1. 1.Department of Imaging and MedicineCedars-Sinai Medical CenterLos Angeles
  2. 2.Artificial Intelligence in Medicine/Department of ImagingCedars-Sinai Medical CenterLos Angeles
  3. 3.Oregon Heart and Vascular InstituteSacred Heart Medical CenterEugene
  4. 4.Department of Human PhysiologyUniversity of OregonEugene

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