Automated calcium scores collected during myocardial perfusion imaging improve identification of obstructive coronary artery disease
Background: Myocardial perfusion imaging (MPI) is an accurate noninvasive test for patients with suspected obstructive coronary artery disease (CAD) and coronary artery calcium (CAC) score is known to be a powerful predictor of cardiovascular events. Collection of CAC scores simultaneously with MPI...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-02-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906719302088 |
| _version_ | 1818528649184280576 |
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| author | Mirthe Dekker Farahnaz Waissi Ingrid E.M. Bank Nikolas Lessmann Ivana Išgum Birgitta K. Velthuis Asbjørn M. Scholtens Geert E. Leenders Gerard Pasterkamp Dominique P.V. de Kleijn Leo Timmers Arend Mosterd |
| author_facet | Mirthe Dekker Farahnaz Waissi Ingrid E.M. Bank Nikolas Lessmann Ivana Išgum Birgitta K. Velthuis Asbjørn M. Scholtens Geert E. Leenders Gerard Pasterkamp Dominique P.V. de Kleijn Leo Timmers Arend Mosterd |
| author_sort | Mirthe Dekker |
| collection | DOAJ |
| description | Background: Myocardial perfusion imaging (MPI) is an accurate noninvasive test for patients with suspected obstructive coronary artery disease (CAD) and coronary artery calcium (CAC) score is known to be a powerful predictor of cardiovascular events. Collection of CAC scores simultaneously with MPI is unexplored. Aim: We aimed to investigate whether automatically derived CAC scores during myocardial perfusion imaging would further improve the diagnostic accuracy of MPI to detect obstructive CAD. Methods: We analyzed 150 consecutive patients without a history of coronary revascularization with suspected obstructive CAD who were referred for 82Rb PET/CT and available coronary angiographic data. Myocardial perfusion was evaluated both semi quantitatively as well as quantitatively according to the European guidelines. CAC scores were automatically derived from the low-dose attenuation correction CT scans using previously developed software based on deep learning. Obstructive CAD was defined as stenosis >70% (or >50% in the left main coronary artery) and/or fractional flow reserve (FFR) ≤0.80. Results: In total 58% of patients had obstructive CAD of which seventy-four percent were male. Addition of CAC scores to MPI and clinical predictors significantly improved the diagnostic accuracy of MPI to detect obstructive CAD. The area under the curve (AUC) increased from 0.87 to 0.91 (p: 0.025). Sensitivity and specificity analysis showed an incremental decrease in false negative tests with our MPI + CAC approach (n = 14 to n = 4), as a consequence an increase in false positive tests was seen (n = 11 to n = 28). Conclusion: CAC scores collected simultaneously with MPI improve the detection of obstructive coronary artery disease in patients without a history of coronary revascularization. Keywords: Coronary artery calcium, Obstructive coronary artery disease, Myocardial perfusion imaging, Deep learning, Cardiovascular imaging |
| first_indexed | 2024-12-11T06:52:44Z |
| format | Article |
| id | doaj.art-8f7ae873c8114990956cad864bcf62d2 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-12-11T06:52:44Z |
| publishDate | 2020-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-8f7ae873c8114990956cad864bcf62d22022-12-22T01:16:51ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672020-02-0126Automated calcium scores collected during myocardial perfusion imaging improve identification of obstructive coronary artery diseaseMirthe Dekker0Farahnaz Waissi1Ingrid E.M. Bank2Nikolas Lessmann3Ivana Išgum4Birgitta K. Velthuis5Asbjørn M. Scholtens6Geert E. Leenders7Gerard Pasterkamp8Dominique P.V. de Kleijn9Leo Timmers10Arend Mosterd11Department of Vascular Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Department of Cardiology, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Corresponding author at: Department of Cardiology, UMC Utrecht, Heidelberglaan 100, PO Box: Q05.2.314, 3508 GA Utrecht, the Netherlands.Department of Vascular Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Department of Cardiology, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the NetherlandsDepartment of Cardiology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, the NetherlandsImage Sciences Institute, University Medical Center Utrecht, the NetherlandsImage Sciences Institute, University Medical Center Utrecht, the NetherlandsDepartment of Radiology, University Medical Center Utrecht, the NetherlandsDepartment of Nuclear Medicine, Meander Medical Center, the NetherlandsDepartment of Cardiology, University Medical Center Utrecht, the NetherlandsDepartment of Clinical Chemistry and Hematology, University Medical Center Utrecht, the NetherlandsDepartment of Vascular Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Netherlands Heart Institute, Moreelsepark 1, 3511 EP Utrecht, the NetherlandsDepartment of Cardiology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, the Netherlands; Department of Cardiology, University Medical Center Utrecht, the NetherlandsDepartment of Cardiology, Meander Medical Center, Maatweg 3, 3813 TZ Amersfoort, the NetherlandsBackground: Myocardial perfusion imaging (MPI) is an accurate noninvasive test for patients with suspected obstructive coronary artery disease (CAD) and coronary artery calcium (CAC) score is known to be a powerful predictor of cardiovascular events. Collection of CAC scores simultaneously with MPI is unexplored. Aim: We aimed to investigate whether automatically derived CAC scores during myocardial perfusion imaging would further improve the diagnostic accuracy of MPI to detect obstructive CAD. Methods: We analyzed 150 consecutive patients without a history of coronary revascularization with suspected obstructive CAD who were referred for 82Rb PET/CT and available coronary angiographic data. Myocardial perfusion was evaluated both semi quantitatively as well as quantitatively according to the European guidelines. CAC scores were automatically derived from the low-dose attenuation correction CT scans using previously developed software based on deep learning. Obstructive CAD was defined as stenosis >70% (or >50% in the left main coronary artery) and/or fractional flow reserve (FFR) ≤0.80. Results: In total 58% of patients had obstructive CAD of which seventy-four percent were male. Addition of CAC scores to MPI and clinical predictors significantly improved the diagnostic accuracy of MPI to detect obstructive CAD. The area under the curve (AUC) increased from 0.87 to 0.91 (p: 0.025). Sensitivity and specificity analysis showed an incremental decrease in false negative tests with our MPI + CAC approach (n = 14 to n = 4), as a consequence an increase in false positive tests was seen (n = 11 to n = 28). Conclusion: CAC scores collected simultaneously with MPI improve the detection of obstructive coronary artery disease in patients without a history of coronary revascularization. Keywords: Coronary artery calcium, Obstructive coronary artery disease, Myocardial perfusion imaging, Deep learning, Cardiovascular imaginghttp://www.sciencedirect.com/science/article/pii/S2352906719302088 |
| spellingShingle | Mirthe Dekker Farahnaz Waissi Ingrid E.M. Bank Nikolas Lessmann Ivana Išgum Birgitta K. Velthuis Asbjørn M. Scholtens Geert E. Leenders Gerard Pasterkamp Dominique P.V. de Kleijn Leo Timmers Arend Mosterd Automated calcium scores collected during myocardial perfusion imaging improve identification of obstructive coronary artery disease International Journal of Cardiology: Heart & Vasculature |
| title | Automated calcium scores collected during myocardial perfusion imaging improve identification of obstructive coronary artery disease |
| title_full | Automated calcium scores collected during myocardial perfusion imaging improve identification of obstructive coronary artery disease |
| title_fullStr | Automated calcium scores collected during myocardial perfusion imaging improve identification of obstructive coronary artery disease |
| title_full_unstemmed | Automated calcium scores collected during myocardial perfusion imaging improve identification of obstructive coronary artery disease |
| title_short | Automated calcium scores collected during myocardial perfusion imaging improve identification of obstructive coronary artery disease |
| title_sort | automated calcium scores collected during myocardial perfusion imaging improve identification of obstructive coronary artery disease |
| url | http://www.sciencedirect.com/science/article/pii/S2352906719302088 |
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