SMARTVis improves diagnostics by fusing cardiac CTA and SPECT MPI data

Combining CT angiography (CTA) and SPECT MPI is useful for the evaluation of coronary artery disease (CAD) and shows more diagnostic benefit than just one of the modalities or consecutive use of the two technologies, according to a study published Jan. 1 in the Journal of Nuclear Medicine.

Researchers, including Hortense A. Kirisli, PhD, from the department of medical informatics and Biomedical Imaging Group Rotterdam at the Erasmus Medical Center in Rotterdam, The Netherlands, assessed the advantages of using a software-based CTA/SPECT MPI image fusion system versus separate but side-by-side interpretation for subjects showing signs of CAD.

“The results of our case study demonstrated that in several cases the integrated analysis of cardiac CTA and SPECT MPI has a clinical benefit, in the sense that there was both an increase in inter-observer agreement and better agreement between therapy planning decisions and the reference standard,” wrote Kirisli et al.

For this study, a total of 17 patients with suspected CAD who had undergone both CTA and SPECT MPI within 90 days were assessed further using a synchronized multimodal heart visualization (SMARTVis) system analyzed by four experts at two medical institutions. First, a side-by-side interpretation of structured CTA and SPECT data was performed and then a fused version was also interpreted and compared. Results showed that simultaneous analysis of both modalities led to higher sensitivity and specificity, and inter-reader agreement jumped by 10 points to 84 percent. Readers 1 through 4 revealed sensitivities that led to referred revascularization. Individual reader sensitivities were 100 percent, 90 percent, 70 percent and 80 precent, respectively, and specificities were 94 percent, 83 precent, 100 percent and 100.

“The fused interpretation led to a more accurate diagnosis, reflected in an increase in the individual observers’ sensitivity and specificity to correctly refer for invasive angiography eventually followed by revascularization,” the authors wrote.

 

 

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