从PET生物标志物对冠状动脉疾病的诊断进行可解释AI的多中心评估
Wenhao Zhang1,2, Jacek Kwiecinski3, Aakash Shanbhag1,4
1Artificial Intelligence in Medicine Research Center, Departments of Biomedical Sciences, Medicine, and Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
NPJ digital medicine
|January 14, 2026
概括
一个整合心脏正子发射断层扫描/计算机断层扫描 (PET/CT) 影像生物标志物的人工智能 (AI) 模型显著改善了阻塞性冠状动脉疾病 (CAD) 的诊断. 这个人工智能工具为CAD提供了自动化和可解释的预测.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 人工智能的人工智能
背景情况:
- 使用PET/CT进行心肌输液成像 (MPI) 提供了冠状动脉疾病 (CAD) 诊断的多种生物标志物.
- 这些生物标志物通常被独立分析,这可能会限制诊断准确度.
研究的目的:
- 开发和验证一个人工智能 (AI) 模型,集成关键的PET/CT MPI参数,以提高阻塞性CAD的诊断.
- 将AI模型的诊断性能与经验丰富的医生和个人成像生物标志物进行比较.
主要方法:
- 进行了对1664名侵袭性冠状动脉血管学患者的回顾性分析.
- 一个XGBoostAI模型使用10个图像衍生参数进行训练,包括冠状动脉 (CAC) 评分,射出分数,心肌血流 (MBF),心肌流量储备 (MFR) 和总 perfusion deficit (TPD).
- 外部验证是在三个独立的网站进行的.
主要成果:
- 人工智能模型在测试队伍中实现了0.83的接收器操作特征曲线 (AUC) 下的面积,超过了经验丰富的医生 (AUC 0.80) 和个人生物标志物,如缺血性TPD (AUC 0.79) 和MFR (AUC 0.75).
- 人工智能模型在不同患者人口统计学 (性别,BMI,年龄) 中表现一致.
结论:
- 通过人工智能模型整合多个PET/CT MPI参数,包括输液,流量和CAC评分,可显著提高阻塞性CAD的诊断准确性.
- 人工智能模型提供自动化,可解释的预测,为CAD诊断提供了有价值的工具.
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