ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2023
Integration of coronary artery calcium scoring from CT attenuation scans by machine learning improves prediction of adverse cardiovascular events in patients undergoing SPECT/CT myocardial perfusion imaging.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Meta-analysis of the effectiveness of heparin in suppressing physiological myocardial FDG uptake in PET/CT.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Pooled it
- Hidden risk in normal myocardial perfusion scans: AI-detected proximal coronary calcium on CT attenuation maps improves prognosis.European journal of nuclear medicine and molecular imaging · 2026Article
- 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.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2025Article
- Automated computation of the HEART score with the GPT-4 large language model.The American journal of emergency medicine · 2025Article
- AI in SPECT Imaging: Opportunities and Challenges.Seminars in nuclear medicine · 2025Review
- Coronary artery calcium measurement on attenuation correction computed tomography using artificial intelligence: correlation with coronary flow capacity and prognosis.European journal of nuclear medicine and molecular imaging · 2025Article
- CAD at the Intersection of Cardiology and Rheumatology: Focus on Cardiovascular Imaging.Methodist DeBakey cardiovascular journal · 2025Review
- The Updated Registry of Fast Myocardial Perfusion Imaging with Next-Generation SPECT (REFINE SPECT 2.0).Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2024Article
- Automated vessel-specific coronary artery calcification quantification with deep learning in a large multi-centre registry.European heart journal. Cardiovascular Imaging · 2024Article
- Artificial Intelligence Predicts Hospitalization for Acute Heart Failure Exacerbation in Patients Undergoing Myocardial Perfusion Imaging.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2024Article
- CT attenuation correction improves quantitative risk prediction by cardiac SPECT in obese patients.European journal of nuclear medicine and molecular imaging · 2024Article
- Comparison of the prognostic value between quantification and visual estimation of coronary calcification from attenuation CT in patients undergoing SPECT myocardial perfusion imaging.The international journal of cardiovascular imaging · 2024Article
- Future of Radionuclide Myocardial Perfusion Imaging: Transitioning from SPECT to PET.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundMachine learning (ML) has been previously applied for prognostication in patients undergoing SPECT myocardial perfusion imaging (MPI). We evaluated whether including attenuation CT coronary artery calcification (CAC) scoring improves ML prediction of major adverse cardiovascular events (MACE) in patients undergoing SPECT/CT MPI.
methodsFrom the REFINE SPECT Registry 4770 patients with SPECT/CT performed at a single center were included (age: 64 ± 12 years, 45% female). ML algorithm (XGBoost) inputs were clinical risk factors, stress variables, SPECT imaging parameters, and expert-observer CAC scoring using CT attenuation correction scans performed to obtain CT attenuation maps. The ML model was trained and validated using tenfold hold-out validation. Receiver Operator Characteristics (ROC) curves were analyzed for prediction of MACE. MACE-free survival was evaluated with standard survival analyses.
resultsDuring a median follow-up of 24.1 months, 475 patients (10%) experienced MACE. Higher area under the ROC curve for MACE was observed with ML when CAC scoring was included (CAC-ML score, 0.77, 95% confidence interval [CI] 0.75-0.79) compared to ML without CAC (ML score, 0.75, 95% CI 0.73-0.77, P = .005) and when compared to CAC score alone (0.71, 95% CI 0.68-0.73, P < .001). Among clinical, imaging, and stress parameters, CAC score had highest variable importance for ML. On survival analysis patients with high CAC-ML score (> 0.091) had higher event rate when compared to patients with low CAC-ML score (hazard ratio 5.3, 95% CI 4.3-6.5, P < .001).
conclusionIntegration of attenuation CT CAC scoring improves the predictive value of ML risk score for MACE prediction in patients undergoing SPECT MPI.
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