Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2025
Integrating perfusion with AI-derived coronary calcium on CT attenuation scans to improve selection of low-risk studies for stress-only SPECT myocardial perfusion imaging.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Miller Robert J H, Barrett Orit, Shanbhag Aakash, Rozanski Alan, Dey Damini, Lemley Mark, Van Kriekinge Serge D, Kavanagh Paul B, Feher Attila, Miller Edward J, Einstein Andrew J, Ruddy Terrence D, Bateman Timothy, Kaufmann Philip A, Liang Joanna X, Berman Daniel S, Slomka Piotr J
Аннотация
BACKGROUND: In many contemporary laboratories, a completely normal stress perfusion single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) is required for rest imaging cancelation. We hypothesized that an artificial intelligence (AI)-derived coronary artery calcium (CAC) score of 0 from computed tomography attenuation correction (CTAC) scans obtained during hybrid SPECT/CT may identify additional patients at a low risk of major adverse cardiovascular events (MACEs) who could be selected for stress-only imaging.
METHODS: Patients without known coronary artery disease who underwent SPECT/CT MPI and had stress total perfusion deficit (TPD) <5% were included. Stress TPD was categorized as no abnormality (stress TPD: 0%) or minimal abnormality (stress TPD: 1%-4%). CAC was automatically quantified from the CTAC scans. We evaluated associations with MACEs.
RESULTS: In total, 6884 patients (49.4% males and median age: 63 years) were included. Of these, 9.7% experienced MACE (15% non-fatal myocardial infarction, 2.7% unstable angina, 38.5% coronary revascularization and 43.8% deaths). Compared to patients with TPD 0%, those with TPD 1%-4% and CAC 0 had lower MACE risk (hazard ratio [HR]: 0.58; 95% confidence interval [CI]: 0.45-0.76), while those with TPD 1%%-4% and CAC score>0 had a higher MACE risk (HR: 1.90; 95% CI: 1.56-2.30). Compared to canceling rest scans only in patients with normal perfusion (TPD 0%), by canceling rest scans in patients with CAC 0, more than twice as many rest scans (55% vs 25%) could potentially be canceled.
CONCLUSION: Using an AI-derived CAC of 0 on CT scans with hybrid SPECT/CT in patients with a stress TPD <5% can double the proportion of patients in whom stress-only procedures could be safely performed.
METHODS: Patients without known coronary artery disease who underwent SPECT/CT MPI and had stress total perfusion deficit (TPD) <5% were included. Stress TPD was categorized as no abnormality (stress TPD: 0%) or minimal abnormality (stress TPD: 1%-4%). CAC was automatically quantified from the CTAC scans. We evaluated associations with MACEs.
RESULTS: In total, 6884 patients (49.4% males and median age: 63 years) were included. Of these, 9.7% experienced MACE (15% non-fatal myocardial infarction, 2.7% unstable angina, 38.5% coronary revascularization and 43.8% deaths). Compared to patients with TPD 0%, those with TPD 1%-4% and CAC 0 had lower MACE risk (hazard ratio [HR]: 0.58; 95% confidence interval [CI]: 0.45-0.76), while those with TPD 1%%-4% and CAC score>0 had a higher MACE risk (HR: 1.90; 95% CI: 1.56-2.30). Compared to canceling rest scans only in patients with normal perfusion (TPD 0%), by canceling rest scans in patients with CAC 0, more than twice as many rest scans (55% vs 25%) could potentially be canceled.
CONCLUSION: Using an AI-derived CAC of 0 on CT scans with hybrid SPECT/CT in patients with a stress TPD <5% can double the proportion of patients in whom stress-only procedures could be safely performed.