Computer-aided diagnosis system outperforms scoring analysis in myocardial perfusion imaging.
BACKGROUND
The aim of this myocardial perfusion imaging (MPI) study was to compare the diagnostic performance of two computer-aided diagnosis (CAD) systems, EXINI Heart(TM) (EXINI), and PERFEX(TM) (PERFEX) Emory Cardiac Toolbox (ECT), and the summed stress score (SSS) values from both software packages.


METHODS
We studied 1,052 consecutive patients who underwent 2-day stress/rest (99m)Tc-sestamibi MPI studies. The reference standard classifications for the MPI studies were obtained from three experienced physicians who separately classified all cases regarding the presence or absence of ischemia and/or infarction. Automatic processing was carried out using EXINI and PERFEX to obtain CAD results and SSS values based on the 17-segment model.


RESULTS
The three experts' classifications showed ischemia in 257 patients and abnormal studies, i.e., either ischemia or infarction or both, in 318 patients. Accuracy was significantly higher in EXINI than in PERFEX, regarding both the detection of ischemia (87.4 vs 77.6%; P < 0.0001) and the detection of abnormal studies (91.6 vs 67.9%; P < 0.0001). EXINI's CAD system showed a higher specificity than its SSS values (86.8 vs 73.6%; P < 0.0001) at the same level of sensitivity.


CONCLUSIONS
EXINI demonstrated greater diagnostic accuracy for detection of ischemia and abnormal studies than did PERFEX. EXINI CAD also outperformed its SSS analysis.
Department of Molecular and Clinical Medicine, Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Lena
L
Johansson
Lars
L
Edenbrandt
Kenichi
K
Nakajima
Milan
M
Lomsky
Sven-Eric
SE
Svensson
Elin
E
Trägårdh
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods / Q000706:statistics & numerical data*; D015588:Observer Variation; D010363:Pattern Recognition, Automated / Q000379:methods* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software; D012986:Software Validation