Quantification of myocardial perfusion SPECT using freeware package (cardioBull)

Objective We have developed freeware package for automatically quantifying myocardial perfusion and 123Ilabeled radiopharmaceutical single-photon emission computed tomography (SPECT), which is called ‘‘cardioBull’’. We aim to evaluate diagnostic performance of the detection of coronary artery disease (CAD) on the developed software in comparison with commercially available software package [Quantitative Perfusion SPECT (QPS)]. Methods Stress-rest 99mTc-sestamibi myocardial perfusion SPECT was performed in 36 patients with CAD and 35 control patients. A C75% stenosis in the coronary artery was identified by coronary angiography in the CAD group. Segmental perfusion defect score was automatically calculated by both cardioBull and QPS software. Summed stress score (SSS) was obtained to detect CAD by the receiver operator characteristic (ROC) analysis. Areas under the ROC curves (AUC) were calculated in patientbased and coronary-based analyses. Results Mean SSSs showed no significant difference between cardioBull and QPS (6.0 ± 7.1 vs. 5.6 ± 7.0). The AUC for cardioBull was equivalent to that for QPS (0.91 ± 0.04 vs. 0.87 ± 0.04, p = n.s.). Sensitivity, specificity, and accuracy for cardioBull were 89, 74, and 82%, respectively. For the regional detection of CAD, the AUC showed largest value in left anterior descending coronary artery (LAD) territory (0.86 ± 0.06 for cardioBull, 0.87 ± 0.06 for QPS, p = n.s.). Sensitivity, specificity and accuracy of cardioBull were 70, 88, and 83% for the LAD; 91, 62, and 66% for the left circumflex coronary artery (LCx); and 78, 69, and 70% for the right coronary artery (RCA), respectively. Conclusions The AUC, sensitivity, specificity and accuracy for the detection of CAD showed high diagnostic performance on the developed software. In addition, the developed software provided comparable diagnostic performance to the commercially available software package.