Machine and deep learning models for accurate detection of ischemia and scar with myocardial blood flow PET imaging.

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Abstract

Quantification of myocardial blood flow (MBF) is used for non-invasive diagnosis of patients with coronary artery disease (CAD). This study compared traditional statistics, machine learning, and deep learning techniques in their ability to diagnose disease using only the rest and stress MBF values.This study included 3,245 rest and stress rubidium-82 PET studies and matching diagnostic labels from perfusion reports. Standard logistic regression, lasso logistic regression, support vector machine, random forest, multilayer perceptron and dense U-Net were compared for per-patient detection and per-vessel localization of scar and ischemia.Receiver-operator characteristic area under the curve (AUC) of machine learning models was significantly higher than those of traditional statistics models for per-patient detection of disease (0.92-0.95 vs 0.87) but not for per-vessel localization of ischemia or scar. Random forest showed the highest AUC = 0.95 among the different models compared. On the final hold-out set for generalizability, random forest showed AUC of 0.92 for detection and 0.89 for localization of perfusion abnormalities.For per-vessel localization, simple models trained on segmental data performed similarly to a convolutional neural network trained on polar-map data, highlighting the need to justify the use of complex predictive algorithms through comparison with simpler methods.Copyright © 2024. Published by Elsevier Inc.