DOI: 10.1007/s00259-017-3834-xPages: 2280-2289

Diagnostic accuracy of an artificial neural network compared with statistical quantitation of myocardial perfusion images: a Japanese multicenter study

1. Kanazawa University Hospital

2. Nagasaki University Hospital

3. Hakodate Goryoukaku Hospital

4. National Cerebral and Cardiovascular Center

5. Tokyo Medical University Hachioji Medical Center

6. Hyogo Brain and Heart Center

7. Tokyo Women’s Medical University

8. Akita City Hospital

9. Fujita Health University Hospital

10. Tokyo Medical University Hospital

11. Tokyo Medical University Ibaraki Medical Center

12. Public Central Hospital of Matto Ishikawa

13. Kanazawa Medical University

14. University of Gothenburg

Correspondence to:
Kenichi Nakajima
Tel: +81 762652333




Artificial neural networks (ANN) might help to diagnose coronary artery disease. This study aimed to determine whether the diagnostic accuracy of an ANN-based diagnostic system and conventional quantitation are comparable.


The ANN was trained to classify potentially abnormal areas as true or false based on the nuclear cardiology expert interpretation of 1001 gated stress/rest 99mTc-MIBI images at 12 hospitals. The diagnostic accuracy of the ANN was compared with 364 expert interpretations that served as the gold standard of abnormality for the validation study. Conventional summed stress/rest/difference scores (SSS/SRS/SDS) were calculated and compared with receiver operating characteristics (ROC) analysis.


The ANN generated a better area under the ROC curves (AUC) than SSS (0.92 vs. 0.82, p < 0.0001), indicating better identification of stress defects. The ANN also generated a better AUC than SDS (0.90 vs. 0.75, p < 0.0001) for stress-induced ischemia. The AUC for patients with old myocardial infarction based on rest defects was 0.97 (0.91 for SRS, p = 0.0061), and that for patients with and without a history of revascularization based on stress defects was 0.94 and 0.90 (p = 0.0055 and p < 0.0001 vs. SSS, respectively). The SSS/SRS/SDS steeply increased when ANN values (probability of abnormality) were >0.80.


The ANN was diagnostically accurate in various clinical settings, including that of patients with previous myocardial infarction and coronary revascularization. The ANN could help to diagnose coronary artery disease.

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  • Accepted: Sep 6, 2017
  • Online: Sep 26, 2017

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