Development, Diagnostic Performance, and Interobserver Agreement of a (18)F-Flurpiridaz PET Automated Perfusion Quantitation System
| Autor: | Cesare Orlandi, Kenneth Van Train, Jamshid Maddahi, Ernest V. Garcia, René R. Sevag Packard, John R. Votaw, C. David Cooke, Joel Lazewatsky, Kelly M Champagne, James Sayre |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
interobserver variability
Flurpiridaz Cardiology Coronary Artery Disease 030204 cardiovascular system & hematology Interpretation Process Cardiorespiratory Medicine and Haematology Cardiovascular PET MPI Article 030218 nuclear medicine & medical imaging 03 medical and health sciences Myocardial perfusion imaging Automation 0302 clinical medicine diagnostic performance Clinical Research Medicine Humans Radiology Nuclear Medicine and imaging Tomography Heart Disease - Coronary Heart Disease Tomography Emission-Computed Single-Photon Observer Variation Receiver operating characteristic medicine.diagnostic_test business.industry Prevention Myocardial Perfusion Imaging automated relative quantitation Exercise stress Atherosclerosis Pyridazines Perfusion Heart Disease Cardiovascular System & Hematology Positron-Emission Tomography Biomedical Imaging Emission-Computed Radiopharmaceuticals Cardiology and Cardiovascular Medicine business Nuclear medicine Automated method Single-Photon |
| Zdroj: | J Nucl Cardiol Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, vol 29, iss 2 |
| Popis: | BACKGROUND: Computerized methodologies standardize the myocardial perfusion imaging (MPI) interpretation process. METHODS: To develop an automated relative perfusion quantitation approach for (18)F-flurpiridaz, PET MPI studies from all phase III trial participants of (18)F-flurpiridaz were divided into 3 groups. Count distributions were obtained in n=40 normal patients undergoing pharmacological or exercise stress. Then, n=90 additional studies were selected in a derivation group. Following receiver operating characteristic curve analysis, various standard deviations below the mean were used as cutoffs for significant CAD, and interobserver variability determined. Finally, diagnostic performance was compared between blinded visual readers and blinded derivations of automated relative quantitation in the remaining n=548 validation patients. RESULTS: Both approaches yielded comparable accuracies for the detection of global CAD, reaching 71% and 72% by visual reads, and 72% and 68% by automated relative quantitation, when using CAD ≥70% or ≥50% stenosis for significance, respectively. Similar results were observed when analyzing individual coronary territories. In both pharmacological and exercise stress, automated relative quantitation demonstrated significantly more interobserver agreement than visual reads. CONCLUSIONS: Our automated method of (18)F-flurpiridaz relative perfusion analysis provides a quantitative, objective, and highly reproducible assessment of PET MPI in normal and CAD subjects undergoing either pharmacological or exercise stress. |
| Databáze: | OpenAIRE |
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