Rationale and design of the REgistry of Fast Myocardial Perfusion Imaging with NExt generation SPECT (REFINE SPECT)



We aim to establish a multicenter registry collecting clinical, imaging, and follow-up data for patients who undergo myocardial perfusion imaging (MPI) with the latest generation SPECT scanners.


REFINE SPECT (REgistry of Fast Myocardial Perfusion Imaging with NExt generation SPECT) uses a collaborative design with multicenter contribution of clinical data and images into a comprehensive clinical-imaging database. All images are processed by quantitative software. Over 290 individual imaging variables are automatically extracted from each image dataset and merged with clinical variables. In the prognostic cohort, patient follow-up is performed for major adverse cardiac events. In the diagnostic cohort (patients with correlating invasive angiography), angiography and revascularization results within 6 months are obtained.


To date, collected prognostic data include scans from 20,418 patients in 5 centers (57% male, 64.0 ± 12.1 years) who underwent exercise (48%) or pharmacologic stress (52%). Diagnostic data include 2079 patients in 9 centers (67% male, 64.7 ± 11.2 years) who underwent exercise (39%) or pharmacologic stress (61%).


The REFINE SPECT registry will provide a resource for collaborative projects related to the latest generation SPECT-MPI. It will aid in the development of new artificial intelligence tools for automated diagnosis and prediction of prognostic outcomes.

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Figure 1



Body mass index


Coronary artery bypass grafting


Coronary artery disease


Cadmium zinc telluride


Ejection fraction


Invasive coronary angiography


Major adverse cardiac events


Myocardial infarction


Myocardial perfusion imaging


Percutaneous coronary intervention


Single-photon emission computed tomography


Total perfusion deficit


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This research was supported in part by Grant R01HL089765 from the National Heart, Lung, and Blood Institute/National Institutes of Health (NHLBI/NIH) (PI: Piotr Slomka). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.


Drs. Germano, Berman, and Slomka participate in software royalties for QPS software at Cedars-Sinai Medical Center. Dr. Slomka has received research grant support from Siemens Medical Systems. Drs. Berman, Dorbala, Einstein, and Miller have served as consultants for GE Healthcare. Dr. Dorbala has served as a consultant to Bracco Diagnostics; her institution has received grant support from Astellas. Dr. Di Carli has received research grant support from Spectrum Dynamics and consulting honoraria from Sanofi and GE Healthcare. Dr. Ruddy has received research grant support from GE Healthcare and Advanced Accelerator Applications. Dr. Einstein and his institution has received research support from GE Healthcare, Philips Healthcare and Toshiba America Medical Systems. Dr. Miller has served as a consultant for Bracco Inc; and he and his institution has received grant support from Bracco Inc. Dr. Berman’s institution has received grant support from HeartFlow. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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Correspondence to Piotr J. Slomka PhD.

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Slomka, P.J., Betancur, J., Liang, J.X. et al. Rationale and design of the REgistry of Fast Myocardial Perfusion Imaging with NExt generation SPECT (REFINE SPECT). J. Nucl. Cardiol. 27, 1010–1021 (2020). https://doi.org/10.1007/s12350-018-1326-4

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  • High-efficiency SPECT
  • Myocardial perfusion imaging
  • Coronary artery disease
  • Machine learning
  • Artificial intelligence
  • Quantitative analysis