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Morf C, Sartoretti T, Gennari AG, Maurer A, Skawran S, Giannopoulos AA, Sartoretti E, Schwyzer M, Curioni-Fontecedro A, Gebhard C, Buechel RR, Kaufmann PA, Huellner MW, Messerli M. Diagnostic Value of Fully Automated Artificial Intelligence Powered Coronary Artery Calcium Scoring from 18F-FDG PET/CT. Diagnostics (Basel) 2022; 12:diagnostics12081876. [PMID: 36010226 PMCID: PMC9406755 DOI: 10.3390/diagnostics12081876] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/24/2022] [Accepted: 07/27/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives: The objective of this study was to assess the feasibility and accuracy of a fully automated artificial intelligence (AI) powered coronary artery calcium scoring (CACS) method on ungated CT in oncologic patients undergoing 18F-FDG PET/CT. Methods: A total of 100 oncologic patients examined between 2007 and 2015 were retrospectively included. All patients underwent 18F-FDG PET/CT and cardiac SPECT myocardial perfusion imaging (MPI) by 99mTc-tetrofosmin within 6 months. CACS was manually performed on non-contrast ECG-gated CT scans obtained from SPECT-MPI (i.e., reference standard). Additionally, CACS was performed using a cloud-based, user-independent tool (AI-CACS) on ungated CT scans from 18F-FDG-PET/CT examinations. Agatston scores from the manual CACS and AI-CACS were compared. Results: On a per-patient basis, the AI-CACS tool achieved a sensitivity and specificity of 85% and 90% for the detection of CAC. Interscore agreement of CACS between manual CACS and AI-CACS was 0.88 (95% CI: 0.827, 0.918). Interclass agreement of risk categories was 0.8 in weighted Kappa analysis, with a reclassification rate of 44% and an underestimation of one risk category by AI-CACS in 39% of cases. On a per-vessel basis, interscore agreement of CAC scores ranged from 0.716 for the circumflex artery to 0.863 for the left anterior descending artery. Conclusions: Fully automated AI-CACS as performed on non-contrast free-breathing, ungated CT scans from 18F-FDG-PET/CT examinations is feasible and provides an acceptable to good estimation of CAC burden. CAC load on ungated CT is, however, generally underestimated by AI-CACS, which should be taken into account when interpreting imaging findings.
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Affiliation(s)
- Claudia Morf
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland; (C.M.); (T.S.); (A.G.G.); (A.M.); (S.S.); (A.A.G.); (E.S.); (C.G.); (R.R.B.); (P.A.K.); (M.W.H.)
- University of Zurich, 8006 Zurich, Switzerland
| | - Thomas Sartoretti
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland; (C.M.); (T.S.); (A.G.G.); (A.M.); (S.S.); (A.A.G.); (E.S.); (C.G.); (R.R.B.); (P.A.K.); (M.W.H.)
- University of Zurich, 8006 Zurich, Switzerland
| | - Antonio G. Gennari
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland; (C.M.); (T.S.); (A.G.G.); (A.M.); (S.S.); (A.A.G.); (E.S.); (C.G.); (R.R.B.); (P.A.K.); (M.W.H.)
- University of Zurich, 8006 Zurich, Switzerland
| | - Alexander Maurer
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland; (C.M.); (T.S.); (A.G.G.); (A.M.); (S.S.); (A.A.G.); (E.S.); (C.G.); (R.R.B.); (P.A.K.); (M.W.H.)
- University of Zurich, 8006 Zurich, Switzerland
| | - Stephan Skawran
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland; (C.M.); (T.S.); (A.G.G.); (A.M.); (S.S.); (A.A.G.); (E.S.); (C.G.); (R.R.B.); (P.A.K.); (M.W.H.)
- University of Zurich, 8006 Zurich, Switzerland
| | - Andreas A. Giannopoulos
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland; (C.M.); (T.S.); (A.G.G.); (A.M.); (S.S.); (A.A.G.); (E.S.); (C.G.); (R.R.B.); (P.A.K.); (M.W.H.)
- University of Zurich, 8006 Zurich, Switzerland
| | - Elisabeth Sartoretti
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland; (C.M.); (T.S.); (A.G.G.); (A.M.); (S.S.); (A.A.G.); (E.S.); (C.G.); (R.R.B.); (P.A.K.); (M.W.H.)
- University of Zurich, 8006 Zurich, Switzerland
| | - Moritz Schwyzer
- University of Zurich, 8006 Zurich, Switzerland
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 8091 Zurich, Switzerland;
| | - Alessandra Curioni-Fontecedro
- University of Zurich, 8006 Zurich, Switzerland
- Department of Medical Oncology and Hematology, University Hospital Zurich, 8091 Zurich, Switzerland;
| | - Catherine Gebhard
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland; (C.M.); (T.S.); (A.G.G.); (A.M.); (S.S.); (A.A.G.); (E.S.); (C.G.); (R.R.B.); (P.A.K.); (M.W.H.)
- University of Zurich, 8006 Zurich, Switzerland
- Center for Molecular Cardiology, University of Zurich, 8006 Zurich, Switzerland
| | - Ronny R. Buechel
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland; (C.M.); (T.S.); (A.G.G.); (A.M.); (S.S.); (A.A.G.); (E.S.); (C.G.); (R.R.B.); (P.A.K.); (M.W.H.)
- University of Zurich, 8006 Zurich, Switzerland
| | - Philipp A. Kaufmann
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland; (C.M.); (T.S.); (A.G.G.); (A.M.); (S.S.); (A.A.G.); (E.S.); (C.G.); (R.R.B.); (P.A.K.); (M.W.H.)
- University of Zurich, 8006 Zurich, Switzerland
| | - Martin W. Huellner
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland; (C.M.); (T.S.); (A.G.G.); (A.M.); (S.S.); (A.A.G.); (E.S.); (C.G.); (R.R.B.); (P.A.K.); (M.W.H.)
- University of Zurich, 8006 Zurich, Switzerland
| | - Michael Messerli
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland; (C.M.); (T.S.); (A.G.G.); (A.M.); (S.S.); (A.A.G.); (E.S.); (C.G.); (R.R.B.); (P.A.K.); (M.W.H.)
- University of Zurich, 8006 Zurich, Switzerland
- Correspondence:
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Wellauer V, Morf C, Minetto MA, Place N, Maffiuletti NA. Assessment of quadriceps muscle inactivation with a new electrical stimulation paradigm. Muscle Nerve 2014; 51:117-24. [PMID: 24752594 DOI: 10.1002/mus.24266] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2014] [Indexed: 11/07/2022]
Abstract
INTRODUCTION In this study we evaluated the validity of garment-based quadriceps stimulation (GQS) for assessment of muscle inactivation in comparison with femoral nerve stimulation (FNS). METHODS Inactivation estimates (superimposed doublet torque), self-reported discomfort, and twitch and doublet contractile properties were compared between GQS and FNS in 15 healthy subjects. RESULTS Superimposed doublet torque was significantly lower for GQS than for FNS at 20% and 40% maximum voluntary contraction (MVC) (P < 0.01), but not at 60%, 80%, and 100% MVC. Discomfort scores were systematically lower for GQS than for FNS (P < 0.05). Resting twitch and doublet peak torque were lower for GQS, and time to peak torque was shorter for GQS than for FNS (P < 0.01). CONCLUSIONS GQS can be used with confidence for straightforward evaluation of quadriceps muscle inactivation, whereas its validity for assessment of contractile properties remains to be determined.
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Affiliation(s)
- Vanessa Wellauer
- Neuromuscular Research Laboratory, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland
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