2025
Significance of Coronary Artery Calcifications and Ischemic Electrocardiographic Changes Among Patients Undergoing Myocardial Perfusion Imaging
Kokkinidis D, Kyriakoulis I, Chui P, Agarwal R, Liu Y, Khera R, Sinusas A, Velazquez E, Miller E, Feher A. Significance of Coronary Artery Calcifications and Ischemic Electrocardiographic Changes Among Patients Undergoing Myocardial Perfusion Imaging. JACC Advances 2025, 4: 101618. PMID: 39983619, PMCID: PMC11891677, DOI: 10.1016/j.jacadv.2025.101618.Peer-Reviewed Original ResearchCoronary artery calcificationMyocardial perfusion imagingIschemic ECG changesLow event ratesECG changesNormal perfusionArtery calcificationPerfusion imagingSingle-photon emission computed tomography/computed tomographyStress ECGCAC evaluationPresence of coronary artery calcificationSuspected coronary artery diseaseMedian follow-upEvent ratesIschemic electrocardiographic changesAnalysis to patientsComposite endpoint rateCoronary artery diseaseTomography/computed tomographyPrognostic informationMACE rateFollow-upSubgroup analysisAdverse outcomesArtificial Intelligence-Enhanced Perfusion Scoring Improves the Diagnostic Accuracy of Myocardial Perfusion Imaging.
Miller R, Kavanagh P, Lemley M, Liang J, Sharir T, Einstein A, Fish M, Ruddy T, Kaufmann P, Sinusas A, Miller E, Bateman T, Dorbala S, Di Carli M, Hayes S, Friedman J, Berman D, Dey D, Slomka P. Artificial Intelligence-Enhanced Perfusion Scoring Improves the Diagnostic Accuracy of Myocardial Perfusion Imaging. Journal Of Nuclear Medicine 2025, jnumed.124.268079. PMID: 39978815, DOI: 10.2967/jnumed.124.268079.Peer-Reviewed Original ResearchObstructive coronary artery diseaseCoronary artery diseaseArea under the receiver operating characteristic curveMyocardial perfusion imagingPerfusion scoreDetection of obstructive coronary artery diseaseDiagnostic accuracy of myocardial perfusion imagingPerfusion imagingAccuracy of myocardial perfusion imagingInvasive coronary angiographyCohort of patientsHighest area under the receiver operating characteristic curveLeft main coronary arteryReceiver operating characteristic curveStress TPDDeep learningObstructive CADMedian ageCoronary angiographyArtificial intelligenceDiagnostic performanceDiagnostic accuracyArtery diseaseAI predictionsCoronary artery
2024
The Relationship Between Quantitative Ischemia, Early Revascularization, and Major Adverse Cardiovascular Events A Multicenter Study
Miller R, Bednarski B, Cui Y, Calsavara V, Patel K, Rozanski A, Liang J, Builoff V, Acampa W, Bateman T, Di Carli M, Dorbala S, Einstein A, Fish M, Hauser M, Kaufmann P, Miller E, Ruddy T, Sharir T, Sinusas A, Dey D, Berman D, Slomka P. The Relationship Between Quantitative Ischemia, Early Revascularization, and Major Adverse Cardiovascular Events A Multicenter Study. JACC Advances 2024, 4: 101440. PMID: 39759439, PMCID: PMC11697767, DOI: 10.1016/j.jacadv.2024.101440.Peer-Reviewed Original ResearchMyocardial perfusion imagingEarly revascularizationMyocardial infarctionPerfusion imagingAssociated with reduced riskMedian follow-upImprove patient selectionAssociated with reduced deathSeverity of ischemiaMulticenter registryMale patientsPatient selectionRetrospective analysisFollow-upRandomized trialsRegistry sitesMyocardial ischemiaRevascularizationPatientsIschemiaSurvival analysisAuthors evaluated differencesPropensity scoreRegistryDeathPrognostic significance of phase analysis using SPECT myocardial perfusion imaging in heart failure: a systematic review and meta-analysis
Lee K, Han S, Ryu J, Cho S, Moon D. Prognostic significance of phase analysis using SPECT myocardial perfusion imaging in heart failure: a systematic review and meta-analysis. The International Journal Of Cardiovascular Imaging 2024, 41: 27-35. PMID: 39535673, DOI: 10.1007/s10554-024-03278-6.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiac-Gated Single-Photon Emission Computer-Assisted TomographyFemaleHeart FailureHumansMaleMiddle AgedMyocardial Perfusion ImagingPredictive Value of TestsPrognosisRisk AssessmentRisk FactorsTomography, Emission-Computed, Single-PhotonVentricular Dysfunction, LeftVentricular Function, LeftConceptsLeft ventricular mechanical dyssynchronyMyocardial perfusion SPECTHF patientsCardiac deathHeart failurePrognostic significancePrognostic valueGated SPECTPerfusion SPECTPooled HRMeta-analysisHazard ratioSPECT myocardial perfusion imagingAll-causeVentricular mechanical dyssynchronyAdverse cardiac eventsMyocardial perfusion imagingAdverse cardiovascular eventsPublication biasConfidence intervalsAnalysis of SPECTSystematic reviewRandom-effects modelMechanical dyssynchronyPrognostic factorsThe 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 dataPositron Emission Tomography in the Diagnosis and Management of Cardiac Allograft Vasculopathy
Csecs I, Yakkali S, Feher A. Positron Emission Tomography in the Diagnosis and Management of Cardiac Allograft Vasculopathy. Current Cardiovascular Imaging Reports 2024, 17: 85-92. DOI: 10.1007/s12410-024-09595-7.Peer-Reviewed Original ResearchManagement of CAVPositron emission tomography myocardial perfusion imagingCardiac allograft vasculopathyInvasive coronary angiographyMyocardial perfusion imagingMyocardial flow reservePositron emission tomographyHeart transplant recipientsMyocardial blood flowAllograft vasculopathyTransplant recipientsPET-derived MBFInternational Society for Heart and Lung Transplantation guidelinesCAV detectionAlternative to invasive coronary angiographyEfficacy of positron emission tomographyRoutine surveillance protocolEmission tomographyClass IIa indicationFrequent invasive proceduresReduce radiation exposurePositron emission tomography imagingPrognostic valueCoronary angiographyMulticenter studyRefining Cardiovascular Calcification in the Appraisal of Ischemic Heart
Nguyen V, Fan J, Hafeez I, Nguyen A, Mojibian H. Refining Cardiovascular Calcification in the Appraisal of Ischemic Heart. Cureus 2024, 16: e64328. PMID: 39130835, PMCID: PMC11316457, DOI: 10.7759/cureus.64328.Peer-Reviewed Original ResearchCoronary artery calcificationCardiovascular calcificationPositron emission tomographySuspected ischemiaPerfusion defectsArtery calcificationMedical historyPredictor of myocardial ischemiaNon-contrast computed tomographyRate of cardiovascular eventsAssociation of ischemiaCT attenuation correctionChest computed tomography imagesNegative predictive valueSignificant perfusion defectsAtherosclerotic coronary artery diseaseNuclear stress testingMyocardial perfusion defectsMyocardial perfusion imagingMyocardial perfusion scanCoronary artery diseaseFollow-up dataPatient's medical historyCoronary CTAInvasive angiographyArtificial Intelligence Predicts Hospitalization for Acute Heart Failure Exacerbation in Patients Undergoing Myocardial Perfusion Imaging
Feher A, Bednarski B, Miller R, Shanbhag A, Lemley M, Miras L, Sinusas A, Miller E, Slomka P. Artificial Intelligence Predicts Hospitalization for Acute Heart Failure Exacerbation in Patients Undergoing Myocardial Perfusion Imaging. Journal Of Nuclear Medicine 2024, 65: jnumed.123.266761. PMID: 38548351, PMCID: PMC11064832, DOI: 10.2967/jnumed.123.266761.Peer-Reviewed Original ResearchConceptsMyocardial perfusion imagingHF hospitalizationHeart failureStress left ventricular ejection fractionPerfusion imagingHF exacerbationPredictive of HF hospitalizationsSPECT/CT myocardial perfusion imagingMyocardial perfusionInternational cohortAcute heart failure exacerbationMedian follow-upVentricular ejection fractionReceiver-operating-characteristic curveClinical risk factorsHeart failure exacerbationExternal validation cohortAcute HF exacerbationPrevent HF hospitalizationsImaging parametersCalcium scoreEjection fractionClinical parametersCT scanValidation cohortImpact of cardiac size on diagnostic performance of single-photon emission computed tomography myocardial perfusion imaging: insights from the REgistry of Fast Myocardial Perfusion Imaging with NExt generation single-photon emission computed tomography
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, Castillo M, Liang J, Miller R, Dey D, Berman D, Slomka P, Einstein A. Impact of cardiac size on diagnostic performance of single-photon emission computed tomography myocardial perfusion imaging: insights from the REgistry of Fast Myocardial Perfusion Imaging with NExt generation single-photon emission computed tomography. European Heart Journal - Cardiovascular Imaging 2024, 25: 996-1006. PMID: 38445511, DOI: 10.1093/ehjci/jeae055.Peer-Reviewed Original ResearchSPECT myocardial perfusion imagingMyocardial perfusion imagingCoronary artery diseaseCardiac sizeDetect obstructive coronary artery diseasePerfusion imagingObstructive coronary artery diseaseDetection of coronary artery diseaseNegative predictive valueLeft ventricular volumeSolid-state scannersSmall cardiac sizeCoronary angiographyMale patientsYounger patientsElderly patientsMale sexDiagnostic performanceVentricular volumeArtery diseaseVisual assessmentPatientsPredictive valueElderly ageSPECTAI-Defined Cardiac Anatomy Improves Risk Stratification of Hybrid Perfusion Imaging
Miller R, Shanbhag A, Killekar A, Lemley M, Bednarski B, Kavanagh P, Feher A, Miller E, Bateman T, Builoff V, Liang J, Newby D, Dey D, Berman D, Slomka P. AI-Defined Cardiac Anatomy Improves Risk Stratification of Hybrid Perfusion Imaging. JACC Cardiovascular Imaging 2024, 17: 780-791. PMID: 38456877, PMCID: PMC11222053, DOI: 10.1016/j.jcmg.2024.01.006.Peer-Reviewed Original ResearchComputed tomography attenuation correctionMajor adverse cardiovascular eventsCoronary artery calciumLV massMyocardial perfusion imagingPerfusion imagingSingle-photon emission computed tomography/computed tomographyIncreased risk of MACEAssociated with major adverse cardiovascular eventsRisk of Major Adverse Cardiovascular EventsCardiac chamber volumesMedian follow-upCT-based volumesRight ventricular volumesImprove cardiovascular risk assessmentAdverse cardiovascular eventsQuartile of LV massContinuous net reclassification indexCoronary artery diseaseNet reclassification indexCardiovascular risk assessmentTomography/computed tomographyConsecutive patientsImprove risk predictionPrognostic utilityAI-derived epicardial fat measurements improve cardiovascular risk prediction from myocardial perfusion imaging
Miller R, Shanbhag A, Killekar A, Lemley M, Bednarski B, Van Kriekinge S, Kavanagh P, Feher A, Miller E, Einstein A, Ruddy T, Liang J, Builoff V, Berman D, Dey D, Slomka P. AI-derived epicardial fat measurements improve cardiovascular risk prediction from myocardial perfusion imaging. Npj Digital Medicine 2024, 7: 24. PMID: 38310123, PMCID: PMC10838293, DOI: 10.1038/s41746-024-01020-z.Peer-Reviewed Original ResearchEpicardial adipose tissueMyocardial infarctionPerfusion imagingEpicardial adipose tissue measurementsEpicardial adipose tissue volumeEAT attenuationMedian follow-upIncreased risk of deathEpicardial fat measurementMyocardial perfusion imagingAssociated with cardiovascular riskCoronary artery diseaseAssociated with deathEating measuresRisk of deathEAT volumeLow-dosePrognostic insightsFollow-upCardiovascular riskCardiovascular risk predictionUngated CTArtery diseaseIncreased riskCardiac silhouetteClinical phenotypes among patients with normal cardiac perfusion using unsupervised learning: a retrospective observational study
Miller R, Bednarski B, Pieszko K, Kwiecinski J, Williams M, Shanbhag A, Liang J, Huang C, Sharir T, Hauser M, Dorbala S, Di Carli M, Fish M, Ruddy T, Bateman T, Einstein A, Kaufmann P, Miller E, Sinusas A, Acampa W, Han D, Dey D, Berman D, Slomka P. Clinical phenotypes among patients with normal cardiac perfusion using unsupervised learning: a retrospective observational study. EBioMedicine 2024, 99: 104930. PMID: 38168587, PMCID: PMC10794922, DOI: 10.1016/j.ebiom.2023.104930.Peer-Reviewed Original ResearchMyocardial infarctionMyocardial perfusion imagingBlood InstituteNational HeartPharmacologic stressExternal testing cohortNormal imaging resultsRetrospective observational studyCoronary artery diseasePrevious myocardial infarctionRisk of deathNormal perfusion scanBritish Heart FoundationNational InstituteCluster 4 patientsDistinct phenotypesCardiovascular riskArtery diseaseRisk stratificationPerfusion scanNormal perfusionImaging featuresNormal scansMPI patientsHeart Foundation
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, PMCID: PMC11774509, 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 populationComparison of the prognostic value between quantification and visual estimation of coronary calcification from attenuation CT in patients undergoing SPECT myocardial perfusion imaging
Feher A, Pieszko K, Shanbhag A, Lemley M, Miller R, Huang C, Miras L, Liu Y, Gerber J, Sinusas A, Miller E, Slomka P. Comparison of the prognostic value between quantification and visual estimation of coronary calcification from attenuation CT in patients undergoing SPECT myocardial perfusion imaging. The International Journal Of Cardiovascular Imaging 2023, 40: 185-193. PMID: 37845406, PMCID: PMC466934, DOI: 10.1007/s10554-023-02980-1.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsCoronary artery calcificationMyocardial perfusion imagingCT myocardial perfusion imagingSPECT/CT myocardial perfusion imagingArtery calcificationPrognostic valuePrior coronary stentingAdverse cardiovascular eventsSimilar prognostic valueSPECT myocardial perfusionREFINE SPECT registrySPECT/CTCardiovascular eventsCAC scoringCalcium scoreCoronary calcificationCoronary stentingPrognostic utilitySingle centerCoronary arteryLow doseMyocardial perfusionPerfusion imagingSurvival analysisTime and event-specific deep learning for personalized risk assessment after cardiac perfusion imaging
Pieszko K, Shanbhag A, Singh A, Hauser M, Miller R, Liang J, Motwani M, Kwieciński J, Sharir T, Einstein A, Fish M, Ruddy T, Kaufmann P, Sinusas A, Miller E, Bateman T, Dorbala S, Di Carli M, Berman D, Dey D, Slomka P. Time and event-specific deep learning for personalized risk assessment after cardiac perfusion imaging. Npj Digital Medicine 2023, 6: 78. PMID: 37127660, PMCID: PMC10151323, DOI: 10.1038/s41746-023-00806-x.Peer-Reviewed Original ResearchAcute coronary syndromeMajor adverse cardiovascular eventsMyocardial perfusion imagingCause deathAdverse cardiovascular eventsModifiable risk factorsPrediction of deathPersonalized risk assessmentCardiovascular eventsCoronary syndromeClinical featuresPrognostic valueRisk factorsExternal cohortStandard clinical interpretationPerfusion imagingAbnormality measuresCardiac perfusionTime pointsPatients' explanationsClinical interpretationExternal validationDeathPatientsRisk assessmentUnsupervised learning to characterize patients with known coronary artery disease undergoing myocardial perfusion imaging
Williams M, Bednarski B, Pieszko K, Miller R, Kwiecinski J, Shanbhag A, Liang J, Huang C, Sharir T, Dorbala S, Di Carli M, Einstein A, Sinusas A, Miller E, Bateman T, Fish M, Ruddy T, Acampa W, Hauser M, Kaufmann P, Dey D, Berman D, Slomka P. Unsupervised learning to characterize patients with known coronary artery disease undergoing myocardial perfusion imaging. European Journal Of Nuclear Medicine And Molecular Imaging 2023, 50: 2656-2668. PMID: 37067586, PMCID: PMC10317876, DOI: 10.1007/s00259-023-06218-z.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseMyocardial perfusion imagingCause mortalityTotal perfusion deficitArtery diseaseRisk stratificationPerfusion deficitsHigher body mass indexTomography myocardial perfusion imagingMore diabetes mellitusSPECT myocardial perfusion imagingBetter risk stratificationRisk-stratify patientsBody mass indexREFINE SPECT registrySingle photon emissionDiabetes mellitusMass indexExternal cohortStress imagingMyocardial perfusionPatientsRisk phenotypePerfusion imagingImaging characteristicsIN PATIENTS UNDERGOING NUCLEAR MYOCARDIAL PERFUSION IMAGING, RHEUMATOID ARTHRITIS IS ASSOCIATED WITH INCREASED RISK OF ADVERSE CARDIOVASCULAR EVENTS INDEPENDENT OF MYOCARDIAL ISCHEMIA
Pires J, Oikonomou E, Agarwal R, Liu Y, miller E, Sinusas A, Feher A. IN PATIENTS UNDERGOING NUCLEAR MYOCARDIAL PERFUSION IMAGING, RHEUMATOID ARTHRITIS IS ASSOCIATED WITH INCREASED RISK OF ADVERSE CARDIOVASCULAR EVENTS INDEPENDENT OF MYOCARDIAL ISCHEMIA. Journal Of The American College Of Cardiology 2023, 81: 1467. DOI: 10.1016/s0735-1097(23)01911-3.Peer-Reviewed Original Research
2022
Event-by-Event 3D Continuous Motion Correction Based on a Data-Driven Motion Estimation Algorithm for 82Rb Myocardial Perfusion Imaging
Tsai Y, Fontaine K, Mulnix T, Armstrong I, Hayden C, Spottiswoode B, Casey M, Liu C. Event-by-Event 3D Continuous Motion Correction Based on a Data-Driven Motion Estimation Algorithm for 82Rb Myocardial Perfusion Imaging. 2022, 00: 1-4. DOI: 10.1109/nss/mic44845.2022.10399100.Peer-Reviewed Original ResearchMotion correctionData-driven motion estimationPET/CT scannerSuperior-inferior motionMotion effectsSilicon photomultipliersNEMA phantomReconstruction frameworkPET acquisitionReconstructed image qualityCardiac PETMotion estimation algorithmPatient datasetsImage qualityMyocardial perfusion imagingCorrectionMotion monitoringTemporal resolutionSiPMMotionPhotomultiplierMotion estimationMotion vectorsPhantomCorrection algorithmPET Myocardial Blood Flow for Post-transplant Surveillance and Cardiac Allograft Vasculopathy in Heart Transplant Recipients
Feher A, Miller EJ. PET Myocardial Blood Flow for Post-transplant Surveillance and Cardiac Allograft Vasculopathy in Heart Transplant Recipients. Current Cardiology Reports 2022, 24: 1865-1871. PMID: 36279035, DOI: 10.1007/s11886-022-01804-3.Peer-Reviewed Original ResearchConceptsHeart transplant recipientsAllograft vasculopathyTransplant recipientsPositron emission tomography myocardial perfusionOverall graft survivalPost-transplant surveillanceCardiac allograft vasculopathyHeart transplant patientsTomography myocardial perfusionRecent FindingsMultiple studiesMyocardial perfusion imagingMyocardial blood flowMBF quantificationGraft survivalHeart transplantationTransplant patientsTransplant rejectionSerial monitoringPrognostic performancePET myocardial blood flowBlood flowMyocardial perfusionPerfusion imagingMBF assessmentBlood flow quantificationDirect 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
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