title: Comparison of diagnostic performances of three different software packages in detecting coronary artery disease.
abstract: OBJECTIVE
  Quantification of myocardial perfusion scintigraphy is frequently performed to assist physicians in detecting coronary artery disease (CAD). Software packages provide automated quantification of perfusion data. We aimed to compare the three commonly used software packages, Emory Cardiac Toolbox (ECT v2 and ECT v3), 4D-MSPECT (4DM v2 and 4DM v4) and Quantitative Perfusion SPECT (QPS v3 and QPS v4).
  
  
  METHODS
  We selected 283 patients who had a myocardial perfusion scintigraphy with (201)Tl followed by coronary angiography within 3 months. Summed stress score (SSS), summed difference score (SDS), total stress defect extent (TDE) and regional stress defect extent values were obtained from programs. A ≥70% stenosis in coronary arteries and their major branches was considered positive for CAD. A subgroup of patients was used to form an institutional normal database for QPS and 4DM. Receiver-operating characteristic (ROC) analysis to detect CAD was performed.
  
  
  RESULTS
  Mean SSS ± SD (vendor) for ECT v3, QPS v4 and 4DM v4 were 9.2 ± 7.1, 10.1 ± 6.8 and 5.5 ± 6.1, respectively. Area under the curve (AUC) values of SSS ROC analysis were 0.738 ± 0.031 for QPS v3, 0.755 ± 0.030 for QPS v4, 0.758 ± 0.030 for ECT v2, 0.778 ± 0.029 for ECT v3 and 0.771 ± 0.030 for 4DM v4. The AUC values for TDE were 0.755 ± 0.030 for QPS v4, 0.769 ± 0.030 for ECT v3 and 0.775 ± 0.029 for 4DM v4. The differences were not significant for both SSS and TDE. Differences of AUC between regional stress defect extent values of programs and AUC of SSS between institutional and vendor normal databases were not significant.
  
  
  CONCLUSIONS
  The diagnostic performances of programs to detect CAD are similar. However, there are differences in the magnitudes of the quantitative values produced by the programs.
authors.affiliation: Department of Nuclear Medicine, Gazi University School of Medicine, Besevler, Ankara, Turkey. leventguner@yahoo.com
authors.forename: Levent A
authors.initials: LA
authors.lastname: Guner
authors.forename: Nese Ilgin
authors.initials: NI
authors.lastname: Karabacak
authors.forename: Tansel
authors.initials: T
authors.lastname: Cakir
authors.forename: Ozgur U
authors.initials: OU
authors.lastname: Akdemir
authors.forename: Sinan A
authors.initials: SA
authors.lastname: Kocaman
authors.forename: Atiye
authors.initials: A
authors.lastname: Cengel
authors.forename: Mustafa
authors.initials: M
authors.lastname: Unlu
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D012372:ROC Curve; D012189:Retrospective Studies; D012984:Software; D013312:Stress, Physiological / Q000187:drug effects; D015899:Tomography, Emission-Computed, Single-Photon