What question did this study set out to answer?

The aim is to evaluate the long-term prognostic value of combined expert and automated scoring systems in predicting cardiac events.

January 10, 2026Journal of Imaging0 citationsOpen Access

Long-Term Prognostic Value in Nuclear Cardiology: Expert Scoring Combined with Automated Measurements vs. Angiographic Score

Q: What does this research mean for the field?

In patients with known or suspected coronary artery disease, expert scoring combined with automated measurements shows significantly greater prognostic ability for hard cardiac events compared to angiographic score. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

GAGeorge AngelidisUniversity of Thessaly SGStavroula GiannakouUniversity Hospital of Larissa VVVarvara ValotassiouUniversity of Thessaly

Key Result

In patients with known or suspected CAD, expert scoring combined with automated measurements showed significantly greater prognostic ability for hard cardiac events compared to angiographic score (p <

Key Points

The aim is to evaluate the long-term prognostic value of combined expert and automated scoring systems in predicting cardiac events.
Conducted in a Nuclear Medicine Laboratory with 378 patients having known or suspected coronary artery disease.
Evaluated combined expert readings of SSS, SRS, and SDS with automated measurements.
Compared prognostic values with an angiographic scoring system over a follow-up period of 36 months.
31.7% of patients experienced soft cardiac events; 11.6% experienced hard cardiac events.
Expert scoring combined with automated measurements significantly outperformed the angiographic score (p < 0.001) for both soft and hard events.
Overall, 36.5% of participants experienced any cardiac event.

Structured PICO

Does expert scoring combined with automated measurements of myocardial perfusion imaging improve prognostic ability for cardiac events compared to angiographic score in patients with known or suspected CAD?

Population

378 consecutive patients with known or suspected coronary artery disease (CAD)

Intervention

Expert reading of Summed Stress Score (SSS), Summed Rest Score (SRS), and Summed Difference Score (SDS), combined with automated measurements (using Emory Cardiac Toolbox, Myovation, and Quantitative Perfusion SPECT software packages)

Comparator

Angiographic score (four-point scoring system based on coronary angiographies)

Outcome

Prognostic ability for hard cardiac events and any cardiac eventcomposite

Combining expert reading with automated myocardial perfusion imaging measurements provides superior long-term prognostic value for cardiac events compared to angiographic scoring in patients with known or suspected CAD.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

The evaluation of myocardial perfusion imaging (MPI) studies is based on the visual interpretation of the reconstructed images, while the measurements obtained through software packages may contribute to the investigation, mainly in cases of ambiguous scintigraphic findings. We aimed to investigate the long-term prognostic value of expert reading of Summed Stress Score (SSS), Summed Rest Score (SRS), and Summed Difference Score (SDS), combined with the automated measurements of these parameters, in comparison to the prognostic ability of the angiographic score for soft and hard cardiac events. The study was conducted at the Nuclear Medicine Laboratory of the University of Thessaly, in Larissa, Greece. Overall, 378 consecutive patients with known or suspected coronary artery disease (CAD) were enrolled. Automated measurements of SSS, SRS, and SDS were obtained using the Emory Cardiac Toolbox, Myovation, and Quantitative Perfusion SPECT software packages. Coronary angiographies were scored according to a four-point scoring system (angiographic score). Follow-up data were recorded after phone contact, as well as through review of hospital records. All participants were followed up for at least 36 months. Soft and hard cardiac events were recorded in 31.7% and 11.6% of the sample, respectively, while any cardiac event was recorded in 36.5%. For hard cardiac events, the prognostic value of expert scoring, combined with the prognostic value of the automated measurements, was significantly greater compared to the prognostic ability of the angiographic score (p < 0.001). As far as any cardiac event, the prognostic value of expert scoring, combined with the prognostic value of the automated analyses, was significantly greater compared to the prognostic ability of the angiographic score (p < 0.001). According to our results, in patients with known or suspected CAD, the combination of expert reading and automated measurements of SSS, SRS, and SDS shows a superior prognostic ability in comparison to the angiographic score.

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