Re-evaluating the value of CT-based attenuation correction in Myocardial Perfusion Imaging
Bibliographic record
Abstract
1862 Purpose: The purpose of this literature review paper was to critically re-evaluate and summarize controversy regarding the diagnostic value of CTAC for MPI SPECT/CT studies from the most recently published research papers. Methods: PubMed and OVID Database was used to search for relevant articles, published in 2007 to 2017, with 20 articles selected for review. The following keywords were utilized: SPECT/CT, MPI and CTAC. The articles were rated for quality using QUADAS-2 for primary research, and AMSTAR-2 for systematic reviews. Summary of sensitivity, specificity and diagnostic odds ratio from each of the articles was summarized, along with QUADAS-2 or AMSTAR-2 scores of each article. One article was structured as a systematic review, 18 articles were categorized as primary research, and the last article was eliminated from rating as it was identified as a review paper. Results: Of the 20 articles selected for review, 9 articles supported the use of CTAC as a means of increasing diagnostic quality of MPI studies (average QUADAS-2 score 11.1/18, range 9 to 16). Two articles were ambiguous, making statements that both support and oppose the utilization of CTAC (average QUADAS-2 score 11.25/18). Five articles opposed the use of CTAC, providing alternatives such as gated SPECT without AC (average QUADAS-2 score 11.2/18, range 4 to 18). The final article was identified to be irrelevant to CTAC, as it discussed RAC in its methodology with no mention of CTAC. Methodology of each article varied significantly in terms of individual MPI protocols, radiopharmaceuticals used, as well as choice of stressing agents. Conclusion: Considering the additional radiation dose delivered to the patient with the use of CTAC, efforts have been made to correctly identify and reduce the radiation dose. However, the diagnostic value of CTAC continues to be a controversial topic and systematic reviews on a larger scale must be conducted to settle the controversy. Through comparison of various MPI protocols, radiopharmaceuticals of choice, stressing agents of choice, and changes in specificity, sensitivity, and diagnostic odds ratio of the procedure, more comprehensive conclusion on diagnostic value of CTAC for MPI SPECT/CT can be made.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.073 | 0.286 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.005 |
| Bibliometrics | 0.014 | 0.006 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.008 | 0.008 |
| Open science | 0.005 | 0.002 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".