Cited by 7Cardiac Imaging and DiagnosticsArtificial Intelligence in HealthcareRadiomics and Machine Learning in Medical Imaging

Explainable deep-learning-based ischemia detection using hybrid O-15 H2O perfusion positron emission tomography and computed tomography imaging with clinical data

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Teuho, Jarmo, Schultz, Jussi, Klén, Riku, Juarez-Orozco, Luis Eduardo, Knuuti, Juhani, Saraste, Antti, Ono, Naoaki, Kanaya, Shigehiko·2024·Journal of Nuclear Cardiology

Abstract

BACKGROUND: O perfusion positron emission tomography computed tomography (PET/CT) and coronary CT angiography (CTA) imaging. The classifier uses polar map images with numerical data and visualizes data findings. METHODS: A DLmodel was implemented and evaluated on 138 individuals, consisting of a combined image-and data-based classifier considering 35 clinical, CTA, and PET variables. Data from invasive coronary angiography were used as reference. Performance was evaluated with clinical classification using accuracy (ACC), area under the receiver operating characteristic curve (AUC), F1 score (F1S), sensitivity (SEN), specificity (SPE), precision (PRE), net benefit, and Cohen's Kappa. Statistical testing was conducted using McNemar's test. RESULTS: The DL model had a median ACC = 0.8478, AUC = 0.8481, F1S = 0.8293, SEN = 0.8500, SPE = 0.8846, and PRE = 0.8500. Improved detection of true-positive and false-negative cases, increased net benefit in thresholds up to 34%, and comparable Cohen's kappa was seen, reaching similar performance to clinical reading. Statistical testing revealed no significant differences between DL model and clinical reading. CONCLUSIONS: The combined DL model is a feasible and an effective method in detection of CAD, allowing to highlight important data findings individually in interpretable manner.

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Crossref · 10.1016/j.nuclcard.2024.101889

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  • Some papers studied in this review attempt to incorporate unimodal explainable AI methods, like Shapley values and Grad-CAM.

    “Some papers studied in this review indeed attempt to incorporate (unimodal) explainable AI methods, like Shapley values (Kolk et al., 2024; Sangnark et al., 2024; Teuho et al., 2024; Xu et al., 2022a; Parvin et al., 2024) and Grad-CAM (Sangnark et al., 2024; Teuho et al., 2024).”

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Authors
Teuho, J., Schultz, J., Klén, R., Juarez-Orozco, L. E., Knuuti, J., Saraste, A., Ono, N., & Kanaya, S.
Affiliations
  • University of Turku (FI)
  • Nara Institute of Science and Technology (JP)
Corresponding author
Teuho, Jarmo
Venue
Journal of Nuclear Cardiology
Publisher
Elsevier BV
Published
2024-08
Volume
38
Pages
101889
ISSN
1071-3581 (ISSN-L)
OpenAlex
W4399510790
Cited by
7
References
37
Citations by year
2026: 1 · 2025: 4 · 2024: 2
FWCI
1.78
Type
journal article
Language
en
Open access
Locations
  • Journal of Nuclear Cardiology (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UTUPub (University of Turku) (submittedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • Institutional Repositories DataBase (IRDB) (submittedVersion, cc-by-nc-nd)
Funders
  • Turun Yliopistosäätiö
  • Japan Society for the Promotion of Science (21K12111, 21KK0183, P19748)
  • Finnish Cultural Foundation
  • Turun Yliopisto
  • Academy of Finland (351482, 322019)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
  • Health Sciences › Health Professions › Health Information Management › Artificial Intelligence in Healthcare
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
Keywords
coronary artery disease, myocardial ischemia detection, hybrid PET/CT, explainable deep learning, coronary CT angiography, clinical data integration, invasive coronary angiography, computer-aided diagnosis, model interpretability
MeSH terms
Positron Emission Tomography Computed Tomography, Computed Tomography Angiography, Deep Learning, Aged, Coronary Artery Disease, Female, Humans, Male, Middle Aged, Oxygen Radioisotopes, Sensitivity and Specificity, Coronary Angiography, Myocardial Ischemia, Myocardial Perfusion Imaging

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