Johansson Lena, Edenbrandt Lars, Nakajima Kenichi, Lomsky Milan, Svensson Sven-Eric, Trägårdh Elin
Department of Molecular and Clinical Medicine, Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
J Nucl Cardiol. 2014 Jun;21(3):416-23. doi: 10.1007/s12350-013-9815-y. Epub 2014 Jan 18.
The aim of this myocardial perfusion imaging (MPI) study was to compare the diagnostic performance of two computer-aided diagnosis (CAD) systems, EXINI Heart(TM) (EXINI), and PERFEX(TM) (PERFEX) Emory Cardiac Toolbox (ECT), and the summed stress score (SSS) values from both software packages.
We studied 1,052 consecutive patients who underwent 2-day stress/rest (99m)Tc-sestamibi MPI studies. The reference standard classifications for the MPI studies were obtained from three experienced physicians who separately classified all cases regarding the presence or absence of ischemia and/or infarction. Automatic processing was carried out using EXINI and PERFEX to obtain CAD results and SSS values based on the 17-segment model.
The three experts' classifications showed ischemia in 257 patients and abnormal studies, i.e., either ischemia or infarction or both, in 318 patients. Accuracy was significantly higher in EXINI than in PERFEX, regarding both the detection of ischemia (87.4 vs 77.6%; P < 0.0001) and the detection of abnormal studies (91.6 vs 67.9%; P < 0.0001). EXINI's CAD system showed a higher specificity than its SSS values (86.8 vs 73.6%; P < 0.0001) at the same level of sensitivity.
EXINI demonstrated greater diagnostic accuracy for detection of ischemia and abnormal studies than did PERFEX. EXINI CAD also outperformed its SSS analysis.
本心肌灌注成像（MPI）研究的目的是比较两种计算机辅助诊断（CAD）系统，即EXINI Heart™（EXINI）和PERFEX™（PERFEX）埃默里心脏工具箱（ECT）的诊断性能，以及这两个软件包的负荷总分（SSS）值。
我们研究了1052例连续接受为期2天的负荷/静息（99m）Tc- sestamibi MPI检查的患者。MPI检查的参考标准分类由三位经验丰富的医生给出，他们分别对所有病例的缺血和/或梗死情况进行分类。使用EXINI和PERFEX进行自动处理，以基于17节段模型获得CAD结果和SSS值。
三位专家的分类显示，257例患者存在缺血，318例患者的检查结果异常，即存在缺血或梗死或两者皆有。在检测缺血方面（87.4%对77.6%；P<0.0001）以及检测异常检查方面（91.6%对67.9%；P<0.0001），EXINI的准确性显著高于PERFEX。在相同的敏感性水平下，EXINI的CAD系统显示出比其SSS值更高的特异性（86.8%对73.6%；P<0.0001）。
与PERFEX相比，EXINI在检测缺血和异常检查方面显示出更高的诊断准确性。EXINI CAD也优于其SSS分析。
