2024
The Updated Registry of Fast Myocardial Perfusion Imaging with Next-Generation SPECT (REFINE SPECT 2.0).
Miller R, Lemley M, Shanbhag A, Ramirez G, Liang J, Builoff V, Kavanagh P, Sharir T, Hauser M, Ruddy T, Fish M, Bateman T, Acampa W, Einstein A, Dorbala S, Di Carli M, Feher A, Miller E, Sinusas A, Halcox J, Martins M, Kaufmann P, Dey D, Berman D, Slomka P. The Updated Registry of Fast Myocardial Perfusion Imaging with Next-Generation SPECT (REFINE SPECT 2.0). Journal Of Nuclear Medicine 2024, 65: 1795-1801. PMID: 39362762, PMCID: PMC11533915, DOI: 10.2967/jnumed.124.268292.Peer-Reviewed Original ResearchCoronary artery calciumCT attenuation correction imagesStress total perfusion deficitMyocardial perfusion imagingTotal perfusion deficitAttenuation correction imagesPerfusion imagingREFINE SPECTImprove prediction of adverse outcomesPerfusion deficitsSPECT myocardial perfusion imagingIncreased risk of MACEPredictive of adverse outcomesMedian follow-upInvasive coronary angiographyRisk of MACEAdverse cardiovascular eventsCAC scoreExperience MACECoronary angiographyArtery calciumInternational registryCardiovascular eventsFollow-upClinical data
2023
CT attenuation correction improves quantitative risk prediction by cardiac SPECT in obese patients
Feher A, Pieszko K, Shanbhag A, Lemley M, Bednarski B, Miller R, Huang C, Miras L, Liu Y, Sinusas A, Slomka P, Miller E. CT attenuation correction improves quantitative risk prediction by cardiac SPECT in obese patients. European Journal Of Nuclear Medicine And Molecular Imaging 2023, 51: 695-706. PMID: 37924340, DOI: 10.1007/s00259-023-06484-x.Peer-Reviewed Original ResearchMajor adverse cardiac eventsMyocardial perfusion imagingSPECT myocardial perfusion imagingMACE-free survivalObese patientsPrognostic valueSignificant incremental prognostic valueYale-New Haven HospitalLate coronary revascularizationStress total perfusion deficitAdverse cardiac eventsIncremental prognostic valueNonfatal myocardial infarctionComposite end pointCT myocardial perfusion imagingSuperior prognostic valueSPECT/CT myocardial perfusion imagingTotal perfusion deficitNew Haven HospitalCT attenuation correctionHighest ROC areaStress TPDCoronary revascularizationCardiac eventsPatient population
2022
Direct Risk Assessment From Myocardial Perfusion Imaging Using Explainable Deep Learning
Singh A, Miller RJH, Otaki Y, Kavanagh P, Hauser MT, Tzolos E, Kwiecinski J, Van Kriekinge S, Wei CC, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Liang JX, Huang C, Han D, Dey D, Berman DS, Slomka PJ. Direct Risk Assessment From Myocardial Perfusion Imaging Using Explainable Deep Learning. JACC Cardiovascular Imaging 2022, 16: 209-220. PMID: 36274041, PMCID: PMC10980287, DOI: 10.1016/j.jcmg.2022.07.017.Peer-Reviewed Original ResearchConceptsMyocardial perfusion imagingTotal perfusion deficitNonfatal myocardial infarctionMyocardial infarctionPerfusion imagingTomography myocardial perfusion imagingIschemic total perfusion deficitStress total perfusion deficitTesting groupReceiver-operating characteristic curvePatient-level riskPrediction of deathSingle photon emissionLogistic regression modelsCause mortalityPrimary outcomeHighest quartileRisk stratificationAbnormal perfusionNormal perfusionPerfusion deficitsAdverse event predictionPrognostic accuracyHigh riskMyocardial perfusion
2021
Impact of age, sex, and cardiac size on the diagnostic performance of myocardial perfusion single-photon emission computed tomography: insights from the REFINE SPECT registry
Randazzo M, Elias P, Poterucha T, Sharir T, Fish M, Ruddy T, Kaufmann P, Sinusas A, Miller E, Bateman T, Dorbala S, Di Carli M, Berman D, Slomka P, Einstein A. Impact of age, sex, and cardiac size on the diagnostic performance of myocardial perfusion single-photon emission computed tomography: insights from the REFINE SPECT registry. European Heart Journal 2021, 42: ehab724.0254. DOI: 10.1093/eurheartj/ehab724.0254.Peer-Reviewed Original ResearchCoronary artery diseaseElderly patientsImpact of ageSingle photon emissionDiagnostic performanceYounger patientsFemale patientsCardiac sizeSPECT-MPILower EDVCardiac volumesObstructive coronary artery diseasePrediction of CADTomography myocardial perfusion imagingMyocardial perfusion single-photon emissionDiagnostic accuracyPerfusion single-photon emissionCardiac event rateStress total perfusion deficitReceiver-operating characteristic curveInvasive coronary angiographyEnd-diastolic volumeCardiac chamber sizeAlternative diagnostic modalityTotal perfusion deficitDetermining a minimum set of variables for machine learning cardiovascular event prediction: results from REFINE SPECT registry
Rios R, Miller RJH, Hu LH, Otaki Y, Singh A, Diniz M, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, DiCarli M, Van Kriekinge S, Kavanagh P, Parekh T, Liang JX, Dey D, Berman DS, Slomka P. Determining a minimum set of variables for machine learning cardiovascular event prediction: results from REFINE SPECT registry. Cardiovascular Research 2021, 118: 2152-2164. PMID: 34259870, PMCID: PMC9302886, DOI: 10.1093/cvr/cvab236.Peer-Reviewed Original ResearchConceptsMajor adverse cardiac eventsMyocardial perfusion imagingTotal perfusion deficitPrognostic accuracyREFINE SPECT registryImaging variablesTraditional multivariable modelsMultivariable modelStress total perfusion deficitAdverse cardiac eventsReceiver-operating characteristic curveOptimal risk stratificationTomography (SPECT) MPIComparable prognostic accuracyComparable prognostic performanceHigher prognostic accuracySingle photon emissionCardiovascular event predictionCardiac eventsRisk stratificationClinical variablesPerfusion deficitsPrognostic performancePerfusion imagingCollected variablesClinical Deployment of Explainable Artificial Intelligence of SPECT for Diagnosis of Coronary Artery Disease
Otaki Y, Singh A, Kavanagh P, Miller RJH, Parekh T, Tamarappoo BK, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Cadet S, Liang JX, Dey D, Berman DS, Slomka PJ. Clinical Deployment of Explainable Artificial Intelligence of SPECT for Diagnosis of Coronary Artery Disease. JACC Cardiovascular Imaging 2021, 15: 1091-1102. PMID: 34274267, PMCID: PMC9020794, DOI: 10.1016/j.jcmg.2021.04.030.Peer-Reviewed Original ResearchConceptsTotal perfusion deficitMyocardial perfusion imagingStandard clinical softwareStress total perfusion deficitObstructive CADTomography myocardial perfusion imagingSPECT myocardial perfusion imagingStress myocardial perfusionCoronary artery diseaseReceiver-operating characteristic curveInvasive coronary angiographyClinical softwareReader diagnosisSingle photon emissionTypical clinical workflowArtery diseaseCoronary angiographyPerfusion deficitsDiagnostic findingsMyocardial perfusionPerfusion imagingVentricular volumeStandard clinical workstationPatientsDiagnostic accuracy
2020
Automated quantitative analysis of CZT SPECT stratifies cardiovascular risk in the obese population: Analysis of the REFINE SPECT registry
Klein E, Miller RJH, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Otaki Y, Gransar H, Liang JX, Dey D, Berman DS, Slomka PJ. Automated quantitative analysis of CZT SPECT stratifies cardiovascular risk in the obese population: Analysis of the REFINE SPECT registry. Journal Of Nuclear Cardiology 2020, 29: 727-736. PMID: 32929639, PMCID: PMC8497048, DOI: 10.1007/s12350-020-02334-7.Peer-Reviewed Original ResearchConceptsBody mass indexTotal perfusion deficitStress total perfusion deficitMyocardial perfusion imagingSPECT myocardial perfusion imagingPrognostic accuracyObese populationMajor adverse cardiac event risksCox proportional hazards analysisDifferent obesity categoriesRobust risk stratificationCardiac event riskProportional hazards analysisHigher prognostic accuracyREFINE SPECT registrySoft tissue attenuationQuantitative perfusion analysisMACE riskObesity categoriesCardiovascular riskObese patientsAdjusted analysisMass indexRisk stratificationSignificant obesity
2019
5-Year Prognostic Value of Quantitative Versus Visual MPI in Subtle Perfusion Defects Results From REFINE SPECT
Otaki Y, Betancur J, Sharir T, Hu LH, Gransar H, Liang JX, Azadani PN, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Tamarappoo BK, Germano G, Dey D, Berman DS, Slomka PJ. 5-Year Prognostic Value of Quantitative Versus Visual MPI in Subtle Perfusion Defects Results From REFINE SPECT. JACC Cardiovascular Imaging 2019, 13: 774-785. PMID: 31202740, PMCID: PMC6899217, DOI: 10.1016/j.jcmg.2019.02.028.Peer-Reviewed Original ResearchConceptsMajor adverse cardiac eventsTotal perfusion deficitStress total perfusion deficitMACE rateHazard ratioRate of MACECox proportional hazards analysisTomography myocardial perfusion imagingAdjusted hazard ratioAdverse cardiac eventsNonfatal myocardial infarctionProportional hazards analysisMyocardial perfusion imagingSingle photon emissionCardiac eventsLate revascularizationUnstable anginaRisk stratificationPrognostic valueKaplan-MeierPerfusion abnormalitiesPerfusion deficitsMyocardial infarctionPrognostic studiesMyocardial perfusion
2018
Deep Learning Analysis of Upright-Supine High-Efficiency SPECT Myocardial Perfusion Imaging for Prediction of Obstructive Coronary Artery Disease: A Multicenter Study
Betancur J, Hu LH, Commandeur F, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann P, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Germano G, Otaki Y, Liang JX, Tamarappoo BK, Dey D, Berman DS, Slomka PJ. Deep Learning Analysis of Upright-Supine High-Efficiency SPECT Myocardial Perfusion Imaging for Prediction of Obstructive Coronary Artery Disease: A Multicenter Study. Journal Of Nuclear Medicine 2018, 60: 664-670. PMID: 30262516, PMCID: PMC6495237, DOI: 10.2967/jnumed.118.213538.Peer-Reviewed Original ResearchConceptsTotal perfusion deficitMyocardial perfusion imagingSPECT myocardial perfusion imagingCoronary artery diseaseObstructive diseaseClinical readsArtery diseaseCoronary arteryPerfusion imagingTc-sestamibi myocardial perfusion imagingObstructive coronary artery diseaseLeft main coronary arteryStress myocardial perfusion imagingStress total perfusion deficitMain coronary arteryMajor coronary arteriesLeft ventricular myocardiumHypoperfusion severityRadiotracer countsMulticenter studyPerfusion deficitsNormal limitsVessel sensitivityPatient sensitivityPatientsDeep Learning for Prediction of Obstructive Disease From Fast Myocardial Perfusion SPECT A Multicenter Study
Betancur J, Commandeur F, Motlagh M, Sharir T, Einstein AJ, Bokhari S, Fish MB, Ruddy TD, Kaufmann P, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Germano G, Otaki Y, Tamarappoo BK, Dey D, Berman DS, Slomka PJ. Deep Learning for Prediction of Obstructive Disease From Fast Myocardial Perfusion SPECT A Multicenter Study. JACC Cardiovascular Imaging 2018, 11: 1654-1663. PMID: 29550305, PMCID: PMC6135711, DOI: 10.1016/j.jcmg.2018.01.020.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCoronary CirculationCoronary StenosisDeep LearningFemaleHumansImage Interpretation, Computer-AssistedMaleMiddle AgedMyocardial Perfusion ImagingOrganophosphorus CompoundsOrganotechnetium CompoundsPredictive Value of TestsRadiopharmaceuticalsRegistriesTechnetium Tc 99m SestamibiTomography, Emission-Computed, Single-PhotonConceptsTotal perfusion deficitMyocardial perfusion imagingCoronary artery diseaseObstructive diseaseArtery diseaseVessel coronary artery diseaseTomography myocardial perfusion imagingTetrofosmin myocardial perfusion imagingLarge multicenter populationStress total perfusion deficitReceiver-operating characteristic curveInvasive coronary angiographyLeft ventricular myocardiumSingle photon emissionMyocardial perfusion SPECTMonths of MPIMulticenter populationObstructive stenosisCoronary angiographyMulticenter studyCoronary arteryPerfusion deficitsNormal limitsVessel sensitivityCurrent clinical methods