
Proceedings Paper
Three-class ROC analysis: a sequential decision model developed for the diagnostic task rest-stress myocardial perfusion SPECT imagingFormat | Member Price | Non-Member Price |
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Paper Abstract
Previously we have developed a decision model for three-class ROC analysis where classification
is made three simultaneously, i.e., with a single decision. In this paper, an alternative sequential decision model was
developed for the specific three-class diagnostic procedure of rest-stress myocardial perfusion SPECT (MPS)
imaging. This sequential decision model was developed based on the fact that sometimes this diagnostic task is
performed using a two-step process. First, the stress (99m
Tc) image is read to determine whether a patient is normal
or abnormal based on the presence of a defect in the stress image. If a defect is found, the rest (201Tl) image is then
read to determine whether this is a reversible defect or a fixed defect based on the presence of defect on the rest
image. In fact, in some MPS protocols where sequential stress/rest imaging is performed, the rest imaging is not
performed if there is no defect in the stress image. Therefore, the three-class task is decomposed to a sequence of
two two-class tasks. For this task we determined, by maximizing the expected utility of both steps of the decision
process, that log likelihood ratios were the optimal decision variables and provide the optimal ROC surface under
the assumption that incorrect decisions have equal utilities under the same hypothesis. The properties of the
sequential decision model were then studied. We found that the sequential decision model shares most of the
features of a 2-class ROC curve. While this model was developed in the context of rest-stress MPS, it may have
applications to other two-step diagnostic tasks.
Paper Details
Date Published: 12 March 2008
PDF: 9 pages
Proc. SPIE 6917, Medical Imaging 2008: Image Perception, Observer Performance, and Technology Assessment, 69170E (12 March 2008); doi: 10.1117/12.772674
Published in SPIE Proceedings Vol. 6917:
Medical Imaging 2008: Image Perception, Observer Performance, and Technology Assessment
Berkman Sahiner; David J. Manning, Editor(s)
PDF: 9 pages
Proc. SPIE 6917, Medical Imaging 2008: Image Perception, Observer Performance, and Technology Assessment, 69170E (12 March 2008); doi: 10.1117/12.772674
Show Author Affiliations
Xin He, Johns Hopkins School of Medicine (United States)
Eric C. Frey, Johns Hopkins School of Medicine (United States)
Published in SPIE Proceedings Vol. 6917:
Medical Imaging 2008: Image Perception, Observer Performance, and Technology Assessment
Berkman Sahiner; David J. Manning, Editor(s)
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