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Diagnostic accuracy of semi-automatic quantitative metrics as an alternative to expert reading of CT myocardial perfusion in the CORE320 study.
J Cardiovasc Comput Tomogr. 2018 May - Jun; 12(3):212-219.JC

Abstract

AIMS

To determine the diagnostic accuracy of semi-automatic quantitative metrics compared to expert reading for interpretation of computed tomography perfusion (CTP) imaging.

METHODS

The CORE320 multicenter diagnostic accuracy clinical study enrolled patients between 45 and 85 years of age who were clinically referred for invasive coronary angiography (ICA). Computed tomography angiography (CTA), CTP, single photon emission computed tomography (SPECT), and ICA images were interpreted manually in blinded core laboratories by two experienced readers. Additionally, eight quantitative CTP metrics as continuous values were computed semi-automatically from myocardial and blood attenuation and were combined using logistic regression to derive a final quantitative CTP metric score. For the reference standard, hemodynamically significant coronary artery disease (CAD) was defined as a quantitative ICA stenosis of 50% or greater and a corresponding perfusion defect by SPECT. Diagnostic accuracy was determined by area under the receiver operating characteristic curve (AUC).

RESULTS

Of the total 377 included patients, 66% were male, median age was 62 (IQR: 56, 68) years, and 27% had prior myocardial infarction. In patient based analysis, the AUC (95% CI) for combined CTA-CTP expert reading and combined CTA-CTP semi-automatic quantitative metrics was 0.87(0.84-0.91) and 0.86 (0.83-0.9), respectively. In vessel based analyses the AUC's were 0.85 (0.82-0.88) and 0.84 (0.81-0.87), respectively. No significant difference in AUC was found between combined CTA-CTP expert reading and CTA-CTP semi-automatic quantitative metrics in patient based or vessel based analyses(p > 0.05 for all).

CONCLUSION

Combined CTA-CTP semi-automatic quantitative metrics is as accurate as CTA-CTP expert reading to detect hemodynamically significant CAD.

Authors+Show Affiliations

Devision of Cardiology, Johns Hopkins Hospital and School of Medicine Baltimore, MD, USA.Devision of Cardiology, Johns Hopkins Hospital and School of Medicine Baltimore, MD, USA.Devision of Cardiology, Johns Hopkins Hospital and School of Medicine Baltimore, MD, USA.Rigshospitalet, University of Copenhagen, Denmark.Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Devision of Cardiology, Johns Hopkins Hospital and School of Medicine Baltimore, MD, USA.Toshiba Medical Systems Corporation, Japan.Toshiba Medical Systems Europe B.V., Zoetermeer, The Netherlands.InCor Heart Institute, University of Sao Paulo Medical School, Brazil.Leiden University Medical Center, Leiden, The Netherlands.Mie University Hospital, Tsu, Japan.Charité Medical School, Humboldt, Berlin, Germany.Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Brigham and Women's Hospital, Harvard University, Boston, MA, USA.Devision of Cardiology, Johns Hopkins Hospital and School of Medicine Baltimore, MD, USA.Devision of Cardiology, Johns Hopkins Hospital and School of Medicine Baltimore, MD, USA. Electronic address: jlima@jhmi.edu.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

29730016

Citation

Ostovaneh, Mohammad R., et al. "Diagnostic Accuracy of Semi-automatic Quantitative Metrics as an Alternative to Expert Reading of CT Myocardial Perfusion in the CORE320 Study." Journal of Cardiovascular Computed Tomography, vol. 12, no. 3, 2018, pp. 212-219.
Ostovaneh MR, Vavere AL, Mehra VC, et al. Diagnostic accuracy of semi-automatic quantitative metrics as an alternative to expert reading of CT myocardial perfusion in the CORE320 study. J Cardiovasc Comput Tomogr. 2018;12(3):212-219.
Ostovaneh, M. R., Vavere, A. L., Mehra, V. C., Kofoed, K. F., Matheson, M. B., Arbab-Zadeh, A., Fujisawa, Y., Schuijf, J. D., Rochitte, C. E., Scholte, A. J., Kitagawa, K., Dewey, M., Cox, C., DiCarli, M. F., George, R. T., & Lima, J. A. C. (2018). Diagnostic accuracy of semi-automatic quantitative metrics as an alternative to expert reading of CT myocardial perfusion in the CORE320 study. Journal of Cardiovascular Computed Tomography, 12(3), 212-219. https://doi.org/10.1016/j.jcct.2018.03.010
Ostovaneh MR, et al. Diagnostic Accuracy of Semi-automatic Quantitative Metrics as an Alternative to Expert Reading of CT Myocardial Perfusion in the CORE320 Study. J Cardiovasc Comput Tomogr. 2018 May - Jun;12(3):212-219. PubMed PMID: 29730016.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic accuracy of semi-automatic quantitative metrics as an alternative to expert reading of CT myocardial perfusion in the CORE320 study. AU - Ostovaneh,Mohammad R, AU - Vavere,Andrea L, AU - Mehra,Vishal C, AU - Kofoed,Klaus F, AU - Matheson,Matthew B, AU - Arbab-Zadeh,Armin, AU - Fujisawa,Yasuko, AU - Schuijf,Joanne D, AU - Rochitte,Carlos E, AU - Scholte,Arthur J, AU - Kitagawa,Kakuya, AU - Dewey,Marc, AU - Cox,Christopher, AU - DiCarli,Marcelo F, AU - George,Richard T, AU - Lima,Joao A C, Y1 - 2018/04/03/ PY - 2017/12/21/received PY - 2018/03/16/revised PY - 2018/03/31/accepted PY - 2018/5/8/pubmed PY - 2018/8/28/medline PY - 2018/5/7/entrez KW - Automatic data processing KW - Coronary artery disease KW - Multidetector computed tomography KW - Myocardial perfusion imaging SP - 212 EP - 219 JF - Journal of cardiovascular computed tomography JO - J Cardiovasc Comput Tomogr VL - 12 IS - 3 N2 - AIMS: To determine the diagnostic accuracy of semi-automatic quantitative metrics compared to expert reading for interpretation of computed tomography perfusion (CTP) imaging. METHODS: The CORE320 multicenter diagnostic accuracy clinical study enrolled patients between 45 and 85 years of age who were clinically referred for invasive coronary angiography (ICA). Computed tomography angiography (CTA), CTP, single photon emission computed tomography (SPECT), and ICA images were interpreted manually in blinded core laboratories by two experienced readers. Additionally, eight quantitative CTP metrics as continuous values were computed semi-automatically from myocardial and blood attenuation and were combined using logistic regression to derive a final quantitative CTP metric score. For the reference standard, hemodynamically significant coronary artery disease (CAD) was defined as a quantitative ICA stenosis of 50% or greater and a corresponding perfusion defect by SPECT. Diagnostic accuracy was determined by area under the receiver operating characteristic curve (AUC). RESULTS: Of the total 377 included patients, 66% were male, median age was 62 (IQR: 56, 68) years, and 27% had prior myocardial infarction. In patient based analysis, the AUC (95% CI) for combined CTA-CTP expert reading and combined CTA-CTP semi-automatic quantitative metrics was 0.87(0.84-0.91) and 0.86 (0.83-0.9), respectively. In vessel based analyses the AUC's were 0.85 (0.82-0.88) and 0.84 (0.81-0.87), respectively. No significant difference in AUC was found between combined CTA-CTP expert reading and CTA-CTP semi-automatic quantitative metrics in patient based or vessel based analyses(p > 0.05 for all). CONCLUSION: Combined CTA-CTP semi-automatic quantitative metrics is as accurate as CTA-CTP expert reading to detect hemodynamically significant CAD. SN - 1876-861X UR - https://www.unboundmedicine.com/medline/citation/29730016/Diagnostic_accuracy_of_semi_automatic_quantitative_metrics_as_an_alternative_to_expert_reading_of_CT_myocardial_perfusion_in_the_CORE320_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1934-5925(18)30061-3 DB - PRIME DP - Unbound Medicine ER -