Prognostically safe stress-only single-photon emission computed tomography myocardial perfusion imaging guided by machine learning: report from REFINE SPECT.

European Heart Journal Cardiovascular Imaging
Lien-Hsin HuPiotr J Slomka

Abstract

Single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) stress-only protocols reduce radiation exposure and cost but require clinicians to make immediate decisions regarding rest scan cancellation. We developed a machine learning (ML) approach for automatic rest scan cancellation and evaluated its prognostic safety. In total, 20 414 patients from a solid-state SPECT MPI international multicentre registry with clinical data and follow-up for major adverse cardiac events (MACE) were used to train ML for MACE prediction as a continuous probability (ML score), using 10-fold repeated hold-out testing to separate test from training data. Three ML score thresholds (ML1, ML2, and ML3) were derived by matching the cancellation rates achieved by physician interpretation and two clinical selection rules. Annual MACE rates were compared in patients selected for rest scan cancellation between approaches. Patients selected for rest scan cancellation with ML had lower annualized MACE rates than those selected by physician interpretation or clinical selection rules (ML1 vs. physician interpretation: 1.4 ± 0.1% vs. 2.1 ± 0.1%; ML2 vs. clinical selection: 1.5 ± 0.1% vs. 2.0 ± 0.1%; ML3 vs. stringent clinical selecti...Continue Reading

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Citations

Oct 18, 2020·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Piotr J SlomkaErnest V Garcia
Jan 12, 2021·Frontiers in Cardiovascular Medicine·Karthik SeetharamPartho P Sengupta
Apr 18, 2021·European Journal of Nuclear Medicine and Molecular Imaging·Riemer H J A SlartAntti Saraste
Oct 18, 2020·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Piotr J SlomkaErnest V Garcia
Sep 30, 2021·JAMA Cardiology·Konrad Pieszko, Piotr J Slomka
Mar 14, 2021·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Robert J H MillerPiotr J Slomka
Jan 15, 2022·Annals of Nuclear Medicine·Yuka OtakiPiotr J Slomka

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