Table S1. Intra-class correlation coefficient for inter-rater variability for each parameter with Emory Cardiac Toolbox (ECTb), Quantitative Perfusion SPECT (QPS) and 4D-MSPECT programs.

ECTb / QPS / 4D-MSPECT
Myocardial perfusion
PDS (%) / 0.91 / 0.98 / 0.99
SSS / 0.95 / 0.98 / 0.99
RPD (%) / 0.96 / 0.94 / 0.96
FPD (%) / 0.96 / 0.99 / 0.99
QGS
LVEF (%) / 0.86 / 1.0 / 0.99
EDV (ml) / 0.89 / 1.0 / 1.0
ESV (ml) / 0.87 / 1.0 / 1.0
LV mass (grams) / 0.95 / 0.87 / 1.0

All the correlations were highly significant with p<0.001. EDV: End-diastolic volume, ESV: End-systolic volume, FPD: Fixed perfusion defect, LV: Left ventricular, LVEF: Left ventricular ejection fraction, PDS: Perfusion defect size, RPD: Reversible perfusion defect, SSS: Summed stress score.


Table S2: Bland-Altman Plot with mean difference and 95% confidence intervals (CI).

Mean
(95% CI) / ECTb
Mean Difference (95% CI) / QPS
Mean Difference (95% CI) / 4D-MSPECT
Mean Difference (95% CI)
Myocardial perfusion
PDS (%) / 23 (21 to 26) / 0 (-1 to 1) / -4 (-5 to -2)** / 4 (3 to 5)**
SSS / 14 (12 to 15) / 0 (0 to 1) / -1 (-1 to 0) / 0 (0 to 1)
RPD (%) / 8 (6 to 9) / -1 (-3 to 0)** / -1 (-3 to 0)* / 3 (2 to 4)***
FPD (%) / 16 (14 to 18) / 1 (-1 to 2) / -2 (-3 to -1)** / 1 (0 to 2)*
QGS
LVEF (%) / 49 (46 to 52) / 1 (0 to 1)* / -3 (-4 to -2)*** / 2 (1 to 3)***
EDV (ml) / 154 (140 to 169) / 19 (17 to 22)*** / -16 (-19 to -14)*** / -3 (-5 to -1)***
ESV (ml) / 87 (74 to 99) / 9 (6 to 11)*** / -5 (-6 to -3)*** / -4 (-5 to -3)***
LV mass (grams) / 175 (166 to 183) / 1 (-1 to 3) / 2 (-1 to 4) / -3 (-5 to 0)*

*p<0.05, **p<0.01, ***p<0.001. Average values for each plot were derived from the 3 softwares. Comparisons were made using 1 sample t-test. Parametric tests were chosen for Bland-Altman plots to ease comparisons with other published studies. ECTb: Emory Cardiac Toolbox, EDV: End-diastolic volume, ESV: End-systolic volume, FPD: Fixed perfusion defect, LV: Left ventricular, LVEF: Left ventricular ejection fraction, PDS: Perfusion defect size, QPS: Quantitative Perfusion SPECT, RPD: Reversible perfusion defect, SSS: Summed stress score.


Table S3: Bivariate comparison of (A) Emory cardiac toolbox (ECTb) and Quantitative perfusion SPECT (QPS), (B) ECTb and 4D-MSPEC, and (C) 4D-MSPECT and QPS softwares for discordance in ranking the perfusion defect size (PDS) based on quartiles of PDS.

A / QPS / Total
Quartile 1 / Quartile 2 / Quartile 3 / Quartile 4
ECTb / Quartile 1 / 14 / 11 / 4 / 2 / 31
Quartile 2 / 10 / 11 / 7 / 1 / 29
Quartile 3 / 4 / 6 / 11 / 8 / 29
Quartile 4 / 0 / 5 / 6 / 20 / 31
Total / 28 / 33 / 28 / 31 / 120
B / ECTb / Total
Quartile 1 / Quartile 2 / Quartile 3 / Quartile 4
4D-MSPECT / Quartile 1 / 21 / 9 / 1 / 0 / 31
Quartile 2 / 7 / 11 / 8 / 2 / 28
Quartile 3 / 3 / 7 / 10 / 11 / 31
Quartile 4 / 0 / 2 / 10 / 18 / 30
Total / 31 / 27 / 29 / 31
C / 4D-MSPECT / Total
Quartile 1 / Quartile 2 / Quartile 3 / Quartile 4
QPS / Quartile 1 / 14 / 8 / 5 / 1 / 28
Quartile 2 / 9 / 11 / 10 / 3 / 33
Quartile 3 / 6 / 8 / 8 / 6 / 28
Quartile 4 / 2 / 1 / 8 / 20 / 30
Total / 31 / 28 / 31 / 30