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Published in: Journal of Nuclear Cardiology 5/2020

01-10-2020 | Original Article

Diagnostic performance of an artificial intelligence-driven cardiac-structured reporting system for myocardial perfusion SPECT imaging

Authors: Ernest V. Garcia, PhD, J. Larry Klein, MD, Valeria Moncayo, MD, C. David Cooke, MSEE, Christian Del’Aune, BSEE, Russell Folks, CNMT, Liudmila Verdes Moreiras, MSN, Fabio Esteves, MD

Published in: Journal of Nuclear Cardiology | Issue 5/2020

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Abstract

Objectives

To describe and validate an artificial intelligence (AI)-driven structured reporting system by direct comparison of automatically generated reports to results from actual clinical reports generated by nuclear cardiology experts.

Background

Quantitative parameters extracted from myocardial perfusion imaging (MPI) studies are used by our AI reporting system to generate automatically a guideline-compliant structured report (sR).

Method

A new nonparametric approach generates distribution functions of rest and stress, perfusion, and thickening, for each of 17 left ventricle segments that are then transformed to certainty factors (CFs) that a segment is hypoperfused, ischemic. These CFs are then input to our set of heuristic rules used to reach diagnostic findings and impressions propagated into a sR referred as an AI-driven structured report (AIsR).
The diagnostic accuracy of the AIsR for detecting coronary artery disease (CAD) and ischemia was tested in 1,000 patients who had undergone rest/stress SPECT MPI.

Results

At the high-specificity (SP) level, in a subset of 100 patients, there were no statistical differences in the agreements between the AIsr, and nine experts’ impressions of CAD (P = .33) or ischemia (P = .37). This high-SP level also yielded the highest accuracy across global and regional results in the 1,000 patients. These accuracies were statistically significantly better than the other two levels [sensitivity (SN)/SP tradeoff, high SN] across all comparisons.

Conclusions

This AI reporting system automatically generates a structured natural language report with a diagnostic performance comparable to those of experts.
Appendix
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Metadata
Title
Diagnostic performance of an artificial intelligence-driven cardiac-structured reporting system for myocardial perfusion SPECT imaging
Authors
Ernest V. Garcia, PhD
J. Larry Klein, MD
Valeria Moncayo, MD
C. David Cooke, MSEE
Christian Del’Aune, BSEE
Russell Folks, CNMT
Liudmila Verdes Moreiras, MSN
Fabio Esteves, MD
Publication date
01-10-2020
Publisher
Springer International Publishing
Published in
Journal of Nuclear Cardiology / Issue 5/2020
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-018-1432-3

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