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Intersoftware variability impacts classification of cardiac PET exams.

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Different software for rubidium-82 PET/CT myocardial perfusion imaging (MPI) yield significantly different results. Caution is advised when using these tools interchangeably due to potential clinical variations.

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Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Medical Imaging

Background:

  • Myocardial perfusion imaging (MPI) using 82Rb PET/CT is a key diagnostic tool for coronary artery disease.
  • Existing data processing software for MPI shows conflicting reproducibility results.
  • This study aimed to compare quantitative outcomes and classification accuracy across different MPI software packages.

Purpose of the Study:

  • To evaluate and compare the quantitative results of myocardial perfusion and exam classification from three distinct software packages used for 82Rb PET/CT MPI.
  • To assess the inter-software variability in myocardial blood flow (MBF) and myocardial perfusion reserve (MFR) measurements.
  • To determine the agreement in classifying exams as normal or abnormal across the evaluated software.

Main Methods:

  • Retrospective analysis of rest/stress 82Rb PET/CT MPI data from 55 patients.
  • Data processed using three software packages: Corridor 4DM, QPET, and SyngoMBF.
  • Statistical analysis included repeated-measures ANOVA, Pearson correlation, intraclass correlation coefficients (ICC), Bland-Altman analysis, and Cohen's Kappa.

Main Results:

  • Statistically significant differences (P < 0.05) were observed in mean MBF and MFR values among the three software packages.
  • Corridor4DM reported lower MFR values and classified more exams as abnormal (31/55) compared to SyngoMBF (18/55) and QPET (15/55).
  • Inter-software agreement was moderate between SyngoMBF and QPET (Kappa > 0.5) but minimal with Corridor4DM (Kappa < 0.4).

Conclusions:

  • Quantitative results and exam classifications for 82Rb PET/CT MPI vary significantly depending on the software used.
  • Clinically significant quantitative variations can arise from using different software packages interchangeably.
  • Healthcare providers should exercise caution and be aware of these systematic differences when interpreting MPI results from different software.