Machine learning predicts per-vessel early coronary revascularization after fast myocardial perfusion SPECT: results from multicentre REFINE SPECT registry.
Publication/Presentation Date
5-1-2020
Abstract
AIMS: To optimize per-vessel prediction of early coronary revascularization (ECR) within 90 days after fast single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) using machine learning (ML) and introduce a method for a patient-specific explanation of ML results in a clinical setting.
METHODS AND RESULTS: A total of 1980 patients with suspected coronary artery disease (CAD) underwent stress/rest 99mTc-sestamibi/tetrofosmin MPI with new-generation SPECT scanners were included. All patients had invasive coronary angiography within 6 months after SPECT MPI. ML utilized 18 clinical, 9 stress test, and 28 imaging variables to predict per-vessel and per-patient ECR with 10-fold cross-validation. Area under the receiver operator characteristics curve (AUC) of ML was compared with standard quantitative analysis [total perfusion deficit (TPD)] and expert interpretation. ECR was performed in 958 patients (48%). Per-vessel, the AUC of ECR prediction by ML (AUC 0.79, 95% confidence interval (CI) [0.77, 0.80]) was higher than by regional stress TPD (0.71, [0.70, 0.73]), combined-view stress TPD (AUC 0.71, 95% CI [0.69, 0.72]), or ischaemic TPD (AUC 0.72, 95% CI [0.71, 0.74]), all P < 0.001. Per-patient, the AUC of ECR prediction by ML (AUC 0.81, 95% CI [0.79, 0.83]) was higher than that of stress TPD, combined-view TPD, and ischaemic TPD, all P < 0.001. ML also outperformed nuclear cardiologists' expert interpretation of MPI for the prediction of early revascularization performance. A method to explain ML prediction for an individual patient was also developed.
CONCLUSION: In patients with suspected CAD, the prediction of ECR by ML outperformed automatic MPI quantitation by TPDs (per-vessel and per-patient) or nuclear cardiologists' expert interpretation (per-patient).
Volume
21
Issue
5
First Page
549
Last Page
559
ISSN
2047-2412
Published In/Presented At
Hu, Lien-Hsin et al. “Machine learning predicts per-vessel early coronary revascularization after fast myocardial perfusion SPECT: results from multicentre REFINE SPECT registry.” European heart journal. Cardiovascular Imaging vol. 21,5 (2020): 549-559. doi:10.1093/ehjci/jez177
Disciplines
Medicine and Health Sciences
PubMedID
31317178
Department(s)
Department of Medicine
Document Type
Article