1
|
Yoneyama H, Nakajima K, Taki J, Wakabayashi H, Konishi T, Shibutani T, Okuda K, Onoguchi M. Comparison of Myocardial Ischemia Detection Between Semiconductor and Conventional Anger-type Three-detector SPECT. ANNALS OF NUCLEAR CARDIOLOGY 2021; 7:49-56. [PMID: 36994142 PMCID: PMC10040939 DOI: 10.17996/anc.21-00141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/05/2021] [Accepted: 08/02/2021] [Indexed: 11/19/2022]
Abstract
Objective: Although semiconductor single-photon emission computed tomography (D-SPECT) has been used for myocardial perfusion imaging, few studies have compared its ability to detect myocardial ischemia with that of 3-detector SPECT (GCA9300R). This study used invasive coronary angiography to determine whether the detectability of myocardial ischemia differs between D-SPECT and GCA9300R. Materials and methods: This study included 24 patients who were assessed by coronary angiography within 60 days of myocardial perfusion D-SPECT and GCA9300R. Two nuclear medicine physicians interpreted myocardial perfusion D-SPECT and GCA9300R images with five grades of confidence, then defined regions of ischemia on polar maps. The gold standard was determined by another nuclear cardiology specialist based on integrated assessment of the coronary angiography findings and other clinical information derived from medical charts. The concordance rate and the Cohen kappa (κ) between D-SPECT and GCA9300R were calculated. Results: The sensitivity, specificity, negative and positive predictive values, and the accuracy of patient-based diagnoses were 66.7%, 91.7%, 89.2%, 72.8%, and 85.5%, respectively, for GCA9300R, and 83.3%, 83.3%, 93.7%, 62.4%, and 83.3%, respectively, for D-SPECT. Interpretations of ischemia did not uncover any significant differences between D-SPECT and GCA9300R. The Cohen κ values of D-SPECT and GCA9300 agreed substantially, moderately and marginally for the left circumflex coronary artery (LCX) (0.68), right coronary artery (RCA) (0.43), and left anterior descending coronary artery (LAD) (0.39), respectively. Conclusions: The detectability of myocardial ischemia is comparable between D-SPECT and GCA9300R. Sensitivity is better for D-SPECT than GCA9300R. However, false-positive D-SPECT findings, especially in the apex and inferior wall should be interpreted with caution.
Collapse
Affiliation(s)
- Hiroto Yoneyama
- Department of Radiological Technology, Kanazawa University Hospital
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University
| | - Junichi Taki
- Department of Biotracer Medicine, Graduate School of Medical Science
| | | | - Takahiro Konishi
- Department of Radiological Technology, Kanazawa University Hospital
| | - Takayuki Shibutani
- Department of Health Science, Graduate School of Medical Science, Kanazawa University
| | - Koichi Okuda
- Department of Physics, Kanazawa Medical University
| | - Masahisa Onoguchi
- Department of Health Science, Graduate School of Medical Science, Kanazawa University
| |
Collapse
|
2
|
Ability of artificial intelligence to diagnose coronary artery stenosis using hybrid images of coronary computed tomography angiography and myocardial perfusion SPECT. Eur J Hybrid Imaging 2019; 3:4. [PMID: 34191159 PMCID: PMC8212308 DOI: 10.1186/s41824-019-0052-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 02/19/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Detecting culprit coronary arteries in patients with ischemia using only myocardial perfusion single-photon emission computed tomography (SPECT) can be challenging. This study aimed to improve the detection of culprit regions using an artificial neural network (ANN) to analyze hybrid images of coronary computed tomography angiography (CCTA) and myocardial perfusion SPECT. METHODS This study enrolled 59 patients with stable coronary artery disease (CAD) who had been assessed by coronary angiography within 60 days of myocardial perfusion SPECT. Two nuclear medicine physicians interpreted the myocardial perfusion SPECT and hybrid images with four grades of confidence, then drew regions on polar maps to identify culprit coronary arteries. The gold standard was determined by the consensus of two other nuclear cardiology specialist based on coronary angiography findings and clinical information. The ability to detect culprit coronary arteries was compared among experienced nuclear cardiologists and the ANN. Receiver operating characteristics (ROC) curves were analyzed and areas under the ROC curves (AUC) were determined. RESULTS Using hybrid images, observer A detected CAD in the right (RCA), left anterior descending (LAD), and left circumflex (LCX) coronary arteries with 83.6%, 89.3%, and 94.4% accuracy, respectively and observer B did so with 72.9%, 84.2%, and 89.3%, respectively. The ANN was 79.1%, 89.8%, and 89.3% accurate for each coronary artery. Diagnostic accuracy was comparable between the ANN and experienced nuclear medicine physicians. The AUC was significantly improved using hybrid images in the RCA region (observer A: from 0.715 to 0.835, p = 0.0031; observer B: from 0.771 to 0.843, p = 0.042). To detect culprit coronary arteries in perfusion defects of the inferior wall without using hybrid images was problematic because the perfused areas of the LCX and RCA varied among individuals. CONCLUSIONS Hybrid images of CCTA and myocardial perfusion SPECT are useful for detecting culprit coronary arteries. Diagnoses using artificial intelligence are comparable to that by nuclear medicine physicians.
Collapse
|
3
|
Slomka P, Germano G. Factors affecting appearance of a normal myocardial perfusion scan. J Nucl Cardiol 2018; 25:1655-1657. [PMID: 28361475 DOI: 10.1007/s12350-017-0857-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 03/14/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Piotr Slomka
- Department of Medicine, Cedars-Sinai Medical Center, David Geffen School of Medicine, UCLA, Los Angeles, USA.
| | - Guido Germano
- Department of Medicine, Cedars-Sinai Medical Center, David Geffen School of Medicine, UCLA, Los Angeles, USA
| |
Collapse
|
4
|
Okuda K, Nakajima K, Matsuo S, Kondo C, Sarai M, Horiguchi Y, Konishi T, Onoguchi M, Shimizu T, Kinuya S. Creation and characterization of normal myocardial perfusion imaging databases using the IQ·SPECT system. J Nucl Cardiol 2018; 25:1328-1337. [PMID: 28050865 DOI: 10.1007/s12350-016-0770-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 12/10/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Image acquisition by short-time single-photon emission-computed tomography (SPECT) has been made feasible by IQ·SPECT. The aim of this study was to generate normal databases (NDBs) of thallium-201 (201Tl) myocardial perfusion imaging for IQ·SPECT, and characterize myocardial perfusion distribution. METHODS AND RESULTS We retrospectively enrolled 159 patients with a low likelihood of cardiac diseases from four hospitals in Japan. All patients underwent short-time 201Tl myocardial perfusion IQ·SPECT with or without attenuation and scatter correction (ACSC) in either supine or prone position. The mean myocardial counts were calculated using 17-segment polar maps. Three NDBs were derived from supine and prone images as well as supine images with ACSC. Differences between the supine and prone positions were observed in the uncorrected sex-segregated NDBs in the mid-inferolateral counts (p ≤ 0.016 for males and p ≤ 0.002 for females). Differences between IQ·SPECT and conventional SPECT were also observed in the mid-anterior, inferolateral, and apical lateral counts (p ≤ 0.009 for males and p ≤ 0.003 for females). Apical low counts attributed to myocardial thinning were observed in the apical anterior and apex segments in the supine IQ·SPECT NDB with ACSC. CONCLUSIONS There were significant differences between uncorrected supine and prone NDBs, between uncorrected supine NDB and supine NDB with ACSC, and between uncorrected supine NDB and conventional SPECT NDB. Understanding the pattern of normal distribution in IQ-SPECT short-time acquisitions with and without ACSC will be helpful for interpretation of imaging findings in patients with coronary artery disease (CAD) or low likelihood of CAD and the NDBs will aid in quantitative analysis.
Collapse
Affiliation(s)
- Koichi Okuda
- Department of Physics, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan.
| | - Kenichi Nakajima
- Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Shinro Matsuo
- Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Chisato Kondo
- Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Masayoshi Sarai
- Department of Cardiology, Fujita Health University Hospital, Aichi, Japan
| | - Yoriko Horiguchi
- Department of Cardiology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Takahiro Konishi
- Department of Radiology, Kanazawa University Hospital, Kanazawa, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Kanazawa University, Kanazawa, Japan
| | - Takeshi Shimizu
- Department of Molecular Imaging, Siemens Healthcare K.K., Tokyo, Japan
| | - Seigo Kinuya
- Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| |
Collapse
|
5
|
Galt JR. New techniques, distinctive population, unique normal databases. J Nucl Cardiol 2018; 25:1338-1341. [PMID: 28474193 DOI: 10.1007/s12350-017-0876-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 03/27/2017] [Indexed: 10/19/2022]
Affiliation(s)
- James R Galt
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road, Atlanta, Georgia, 30322, USA.
| |
Collapse
|
6
|
Abstract
PURPOSE OF REVIEW Myocardial perfusion imaging (MPI) with SPECT is performed clinically worldwide to detect and monitor coronary artery disease (CAD). MPI allows an objective quantification of myocardial perfusion at stress and rest. This established technique relies on normal databases to compare patient scans against reference normal limits. In this review, we aim to introduce the process of MPI quantification with normal databases and describe the associated perfusion quantitative measures that are used. RECENT FINDINGS New equipment and new software reconstruction algorithms have been introduced which require the development of new normal limits. The appearance and regional count variations of normal MPI scan may differ between these new scanners and standard Anger cameras. Therefore, these new systems may require the determination of new normal limits to achieve optimal accuracy in relative myocardial perfusion quantification. Accurate diagnostic and prognostic results rivaling those obtained by expert readers can be obtained by this widely used technique. SUMMARY Throughout this review, we emphasize the importance of the different normal databases and the need for specific databases relative to distinct imaging procedures. use of appropriate normal limits allows optimal quantification of MPI by taking into account subtle image differences due to the hardware and software used, and the population studied.
Collapse
|
7
|
Normal values and standardization of parameters in nuclear cardiology: Japanese Society of Nuclear Medicine working group database. Ann Nucl Med 2016; 30:188-99. [PMID: 26897008 PMCID: PMC4819542 DOI: 10.1007/s12149-016-1065-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 01/31/2016] [Indexed: 11/16/2022]
Abstract
As a 2-year project of the Japanese Society of Nuclear Medicine working group activity, normal myocardial imaging databases were accumulated and summarized. Stress-rest with gated and non-gated image sets were accumulated for myocardial perfusion imaging and could be used for perfusion defect scoring and normal left ventricular (LV) function analysis. For single-photon emission computed tomography (SPECT) with multi-focal collimator design, databases of supine and prone positions and computed tomography (CT)-based attenuation correction were created. The CT-based correction provided similar perfusion patterns between genders. In phase analysis of gated myocardial perfusion SPECT, a new approach for analyzing dyssynchrony, normal ranges of parameters for phase bandwidth, standard deviation and entropy were determined in four software programs. Although the results were not interchangeable, dependency on gender, ejection fraction and volumes were common characteristics of these parameters. Standardization of 123I-MIBG sympathetic imaging was performed regarding heart-to-mediastinum ratio (HMR) using a calibration phantom method. The HMRs from any collimator types could be converted to the value with medium-energy comparable collimators. Appropriate quantification based on common normal databases and standard technology could play a pivotal role for clinical practice and researches.
Collapse
|
8
|
Yoshinaga K, Tamaki N. Current status of nuclear cardiology in Japan: Ongoing efforts to improve clinical standards and to establish evidence. J Nucl Cardiol 2015; 22:690-9. [PMID: 25896679 DOI: 10.1007/s12350-015-0136-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 03/27/2015] [Indexed: 11/25/2022]
Abstract
Nuclear cardiology imaging tests are widely performed in Japan as clinical practice. The Japanese nuclear cardiology community has developed new diagnostic imaging tests using (123)I-beta-methyl-p-iodophenyl-pentadecanoic acid, (123)I-metaiodobenzylguanidine, and (18)F-fluorodeoxyglucose PET for detecting cardiac involvement in sarcoidosis. These tests have become popular worldwide. The Japanese Circulation Society and the Japanese Society of Nuclear Cardiology have published clinical imaging guidelines showing indications and standards for the new imaging tests. JSNC is currently striving to improve the standard of clinical practice and is promoting research activities.
Collapse
Affiliation(s)
- Keiichiro Yoshinaga
- Molecular Imaging Research Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan,
| | | |
Collapse
|
9
|
A myocardial perfusion imaging system using a multifocal collimator for detecting coronary artery disease: validation with invasive coronary angiography. Ann Nucl Med 2015; 29:366-70. [DOI: 10.1007/s12149-015-0955-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 01/26/2015] [Indexed: 10/24/2022]
|
10
|
Petretta M, Cuocolo R, Acampa W, Cuocolo A. Quantification of Myocardial Perfusion: SPECT. CURRENT CARDIOVASCULAR IMAGING REPORTS 2012. [DOI: 10.1007/s12410-012-9131-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
11
|
Okuda K, Nakajima K, Hosoya T, Ishikawa T, Matsuo S, Kawano M, Taki J, Kinuya S. Quantification of myocardial perfusion SPECT using freeware package (cardioBull). Ann Nucl Med 2011; 25:571-9. [PMID: 21698436 DOI: 10.1007/s12149-011-0504-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 05/24/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We have developed freeware package for automatically quantifying myocardial perfusion and (123)I-labeled radiopharmaceutical single-photon emission computed tomography (SPECT), which is called "cardioBull". We aim to evaluate diagnostic performance of the detection of coronary artery disease (CAD) on the developed software in comparison with commercially available software package [Quantitative Perfusion SPECT (QPS)]. METHODS Stress-rest (99m)Tc-sestamibi myocardial perfusion SPECT was performed in 36 patients with CAD and 35 control patients. A ≥ 75% stenosis in the coronary artery was identified by coronary angiography in the CAD group. Segmental perfusion defect score was automatically calculated by both cardioBull and QPS software. Summed stress score (SSS) was obtained to detect CAD by the receiver operator characteristic (ROC) analysis. Areas under the ROC curves (AUC) were calculated in patient-based and coronary-based analyses. RESULTS Mean SSSs showed no significant difference between cardioBull and QPS (6.0 ± 7.1 vs. 5.6 ± 7.0). The AUC for cardioBull was equivalent to that for QPS (0.91 ± 0.04 vs. 0.87 ± 0.04, p = n.s.). Sensitivity, specificity, and accuracy for cardioBull were 89, 74, and 82%, respectively. For the regional detection of CAD, the AUC showed largest value in left anterior descending coronary artery (LAD) territory (0.86 ± 0.06 for cardioBull, 0.87 ± 0.06 for QPS, p = n.s.). Sensitivity, specificity and accuracy of cardioBull were 70, 88, and 83% for the LAD; 91, 62, and 66% for the left circumflex coronary artery (LCx); and 78, 69, and 70% for the right coronary artery (RCA), respectively. CONCLUSIONS The AUC, sensitivity, specificity and accuracy for the detection of CAD showed high diagnostic performance on the developed software. In addition, the developed software provided comparable diagnostic performance to the commercially available software package.
Collapse
Affiliation(s)
- Koichi Okuda
- Department of Biotracer Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Yoshinaga K. Cardiovascular Event Risk Assessment Using Myocardial Perfusion Imaging With a View to Wide Clinical Application. Circ J 2011; 75:2318-9. [DOI: 10.1253/circj.cj-11-0841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Keiichiro Yoshinaga
- Department of Photobiology, Division of Molecular · Cellular Imaging, Hokkaido University Graduate School of Medicine
| |
Collapse
|
13
|
Matsuo S, Nakajima K, Kinuya S. Clinical use of nuclear cardiology in the assessment of heart failure. World J Cardiol 2010; 2:344-56. [PMID: 21160612 PMCID: PMC2999043 DOI: 10.4330/wjc.v2.i10.344] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Revised: 09/01/2010] [Accepted: 09/08/2010] [Indexed: 02/06/2023] Open
Abstract
A nuclear cardiology test is the most commonly performed non-invasive cardiac imaging test in patients with heart failure, and it plays a pivotal role in their assessment and management. Quantitative gated single positron emission computed tomography (QGS) is used to assess quantitatively cardiac volume, left ventricular ejection fraction (LVEF), stroke volume, and cardiac diastolic function. Resting and stress myocardial perfusion imaging, with exercise or pharmacologic stress, plays a fundamental role in distinguishing ischemic from non-ischemic etiology of heart failure, and in demonstrating myocardial viability. Diastolic heart failure also termed as heart failure with a preserved LVEF is readily identified by nuclear cardiology techniques and can accurately be estimated by peak filling rate (PFR) and time to PFR. Movement of the left ventricle can also be readily assessed by QGS, with newer techniques such as three-dimensional, wall thickening evaluation aiding its assessment. Myocardial perfusion imaging is also commonly used to identify candidates for implantable cardiac defibrillator and cardiac resynchronization therapies. Neurotransmitter imaging using (123)I-metaiodobenzylguanidine offers prognostic information in patients with heart failure. Metabolism and function in the heart are closely related, and energy substrate metabolism is a potential target of medical therapies to improve cardiac function in patients with heart failure. Cardiac metabolic imaging using (123)I-15-(p-iodophenyl)3-R, S-methylpentadecacoic acid is a commonly used tracer in clinical studies to diagnose metabolic heart failure. Nuclear cardiology tests, including neurotransmitter imaging and metabolic imaging, are now easily preformed with new tracers to refine heart failure diagnosis. Nuclear cardiology studies contribute significantly to guiding management decisions for identifying cardiac risk in patients with heart failure.
Collapse
Affiliation(s)
- Shinro Matsuo
- Shinro Matsuo, Kenichi Nakajima, Seigo Kinuya, Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa 920-8641, Ishikawa, Japan
| | | | | |
Collapse
|
14
|
Nakajima K. Normal values for nuclear cardiology: Japanese databases for myocardial perfusion, fatty acid and sympathetic imaging and left ventricular function. Ann Nucl Med 2010; 24:125-35. [PMID: 20108130 PMCID: PMC2855806 DOI: 10.1007/s12149-009-0337-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Accepted: 12/15/2009] [Indexed: 08/30/2023]
Abstract
Myocardial normal databases for stress myocardial perfusion study have been created by the Japanese Society of Nuclear Medicine Working Group. The databases comprised gender-, camera rotation range- and radiopharmaceutical-specific data-sets from multiple institutions, and normal database files were created for installation in common nuclear cardiology software. Based on the electrocardiography-gated single-photon emission computed tomography (SPECT), left ventricular function, including ventricular volumes, systolic and diastolic functions and systolic wall thickening were also analyzed. Normal databases for fatty acid imaging using 123I-beta-methyl-iodophenyl-pentadecanoic acid and sympathetic imaging using 123I-meta-iodobenzylguanidine were also examined. This review provides lists and overviews of normal values for myocardial SPECT and ventricular function in a Japanese population. The population-specific approach is a key factor for proper diagnostic and prognostic evaluation.
Collapse
Affiliation(s)
- Kenichi Nakajima
- Department of Nuclear Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan.
| |
Collapse
|