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Updated: May 21, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Referring physicians underestimate the extent of abnormalities in final reports from myocardial perfusion imaging
Elin Trägårdh1, Peter Höglund, Mattias Ohlsson
1Clinical Physiology and Nuclear Medicine Unit, Skåne University Hospital, Lund University, Entrance 44, Malmö, 205 05, Sweden. elin.tragardh@med.lu.se.
Background:
It is important that referring physicians and other treating clinicians properly understand the final reports from diagnostic tests. The aim of the study was to investigate whether referring physicians interpret a final report for a myocardial perfusion scintigraphy (MPS) test in the same way that the reading nuclear medicine physician intended.
Methods:
After viewing final reports containing only typical clinical verbiage and images, physicians in nuclear medicine and referring physicians (physicians in cardiology, internal medicine, and general practitioners) independently classified 60 MPS tests for the presence versus absence of ischemia/infarction according to objective grades of 1-5 (1 = No ischemia/infarction, 2 = Probably no ischemia/infarction 3 = Equivocal, 4 = Probable ischemia/infarction, and 5 = Certain ischemia/infarction). When ischemia and/or infarction were thought to be present in the left ventricle, all physicians were also asked to mark the involved segments based on the 17-segment model.
Results:
There was good diagnostic agreement between physicians in nuclear medicine and referring physicians when assessing the general presence versus absence of both ischemia and infarction (median squared kappa coefficient of 0.92 for both). However, when using the 17-segment model, compared to the physicians in nuclear medicine, 12 of 23 referring physicians underestimated the extent of ischemic area while 6 underestimated and 1 overestimated the extent of infarcted area.
Conclusions:
Whereas referring physicians gain a good understanding of the general presence versus absence of ischemia and infarction from MPS test reports, they often underestimate the extent of any ischemic or infarcted areas. This may have adverse clinical consequences and thus the language in final reports from MPS tests might be further improved and standardized.
Insights
Referring physicians understand myocardial perfusion scintigraphy (MPS) reports generally, but often underestimate the extent of ischemia or infarction. Improving report clarity is crucial for patient care.
Area of Science:
- Cardiology
- Nuclear Medicine
- Diagnostic Imaging
Background:
- Accurate interpretation of diagnostic test reports is vital for clinical decision-making.
- Physician understanding of myocardial perfusion scintigraphy (MPS) reports requires investigation.
Purpose of the Study:
- To assess if referring physicians interpret MPS final reports similarly to nuclear medicine physicians.
- To evaluate the concordance in interpreting ischemia and infarction extent.
Main Methods:
- Physicians classified 60 MPS tests for ischemia/infarction presence using a 1-5 grade scale.
- The 17-segment model was used to delineate the extent of ischemic and infarcted areas.
Main Results:
- Good agreement was found in detecting the general presence/absence of ischemia/infarction.
- Referring physicians frequently underestimated the extent of ischemic areas (12/23) and infarcted areas (6/23).
Conclusions:
- While general MPS findings are understood, extent of ischemia/infarction is often underestimated by referring physicians.
- Potential adverse clinical consequences necessitate improved and standardized language in MPS reports.
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