Deep Learning on Bone Scintigraphy to Detect Abnormal Cardiac Uptake at Risk of Cardiac Amyloidosis - Inria - Institut national de recherche en sciences et technologies du numérique Access content directly
Journal Articles JACC: Cardiovascular Imaging Year : 2023

Deep Learning on Bone Scintigraphy to Detect Abnormal Cardiac Uptake at Risk of Cardiac Amyloidosis

Marc-Antoine Delbarre

Abstract

Background Cardiac uptake on technetium-99m whole-body scintigraphy (WBS) is almost pathognomonic of transthyretin cardiac amyloidosis. The rare false positives are often related to light-chain cardiac amyloidosis. However, this scintigraphic feature remains largely unknown, leading to misdiagnosis despite characteristic images. A retrospective review of all WBSs in a hospital database to detect those with cardiac uptake may allow the identification of undiagnosed patients. Objectives The authors sought to develop and validate the first deep learning–based model that automatically detects significant cardiac uptake (≥Perugini grade 2) on WBS from large hospital databases in order to retrieve patients at risk of cardiac amyloidosis. Methods The model is based on a convolutional neural network with image-level labels. The performance evaluation was performed with C-statistics using a 5-fold cross-validation scheme stratified so that the proportion of positive and negative WBSs remained constant across folds and using an external validation data set. Results The training data set consisted of 3,048 images: 281 positives (≥Perugini 2) and 2,767 negatives. The external validation data set consisted of 1,633 images: 102 positives and 1,531 negatives. The performance of the 5-fold cross-validation and external validation was as follows: 98.9% (± 1.0) and 96.1% for sensitivity, 99.5% (± 0.4) and 99.5% for specificity, and 0.999 (SD = 0.000) and 0.999 for the area under the curve of the receiver-operating characteristic curves. Sex, age <90 years, body mass index, injection-acquisition delay, radionuclides, and the indication of WBS only slightly affected performances. Conclusions The authors’ detection model is effective at identifying patients with cardiac uptake ≥Perugini 2 on WBS and may help in the diagnosis of patients with cardiac amyloidosis.

Dates and versions

hal-04082960 , version 1 (26-04-2023)

Identifiers

Cite

Marc-Antoine Delbarre, François Girardon, Lucien Roquette, Paul Blanc-Durand, Marc-Antoine Hubaut, et al.. Deep Learning on Bone Scintigraphy to Detect Abnormal Cardiac Uptake at Risk of Cardiac Amyloidosis. JACC: Cardiovascular Imaging, 2023, ⟨10.1016/j.jcmg.2023.01.014⟩. ⟨hal-04082960⟩
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