BACKGROUND: Two imaging techniques, multislice computed tomography (CT) and magnetic resonance imaging (MRI), have evolved for noninvasive coronary angiography. PURPOSE: To compare CT and MRI for ruling out clinically significant coronary artery disease (CAD) in adults with suspected or known CAD. DATA SOURCES: MEDLINE, EMBASE, and ISI Web of Science searches from inception through 2 June 2009 and bibliographies of reviews. STUDY SELECTION: Prospective English- or German-language studies that compared CT or MRI with conventional coronary angiography in all patients and included sufficient data for compilation of 2 x 2 tables. DATA EXTRACTION: 2 investigators independently extracted patient and study characteristics; differences were resolved by consensus. DATA SYNTHESIS: 89 and 20 studies (comprising 7516 and 989 patients) assessed CT and MRI, respectively. Bivariate analysis of data yielded a mean sensitivity and specificity of 97.2% (95% CI, 96.2% to 98.0%) and 87.4% (CI, 84.5% to 89.8%) for CT and 87.1% (CI, 83.0% to 90.3%) and 70.3% (CI, 58.8% to 79.7%) for MRI. In studies that included only patients with suspected CAD, sensitivity and specificity of CT were 97.6% (CI, 96.1% to 98.5%) and 89.2% (CI, 86.0% to 91.8%). Covariate analysis yielded a significantly higher sensitivity for CT scanners with more than 16 rows (98.1% [CI, 97.0% to 99.0%]; P < 0.050) than for older-generation scanners (95.6% [CI, 94.0% to 97.0%]). Heart rates less than 60 beats/min during CT yielded significantly better values for sensitivity than did higher heart rates (P < 0.001). LIMITATIONS: Few studies investigated coronary angiography with MRI. Only 5 studies were direct head-to-head comparisons of CT and MRI. Covariate analyses explained only part of the observed heterogeneity. CONCLUSION: For ruling out CAD, CT is more accurate than MRI. Scanners with more than 16 rows improve sensitivity, as do slowed heart rates. PRIMARY FUNDING SOURCE: None.
BACKGROUND: Two imaging techniques, multislice computed tomography (CT) and magnetic resonance imaging (MRI), have evolved for noninvasive coronary angiography. PURPOSE: To compare CT and MRI for ruling out clinically significant coronary artery disease (CAD) in adults with suspected or known CAD. DATA SOURCES: MEDLINE, EMBASE, and ISI Web of Science searches from inception through 2 June 2009 and bibliographies of reviews. STUDY SELECTION: Prospective English- or German-language studies that compared CT or MRI with conventional coronary angiography in all patients and included sufficient data for compilation of 2 x 2 tables. DATA EXTRACTION: 2 investigators independently extracted patient and study characteristics; differences were resolved by consensus. DATA SYNTHESIS: 89 and 20 studies (comprising 7516 and 989 patients) assessed CT and MRI, respectively. Bivariate analysis of data yielded a mean sensitivity and specificity of 97.2% (95% CI, 96.2% to 98.0%) and 87.4% (CI, 84.5% to 89.8%) for CT and 87.1% (CI, 83.0% to 90.3%) and 70.3% (CI, 58.8% to 79.7%) for MRI. In studies that included only patients with suspected CAD, sensitivity and specificity of CT were 97.6% (CI, 96.1% to 98.5%) and 89.2% (CI, 86.0% to 91.8%). Covariate analysis yielded a significantly higher sensitivity for CT scanners with more than 16 rows (98.1% [CI, 97.0% to 99.0%]; P < 0.050) than for older-generation scanners (95.6% [CI, 94.0% to 97.0%]). Heart rates less than 60 beats/min during CT yielded significantly better values for sensitivity than did higher heart rates (P < 0.001). LIMITATIONS: Few studies investigated coronary angiography with MRI. Only 5 studies were direct head-to-head comparisons of CT and MRI. Covariate analyses explained only part of the observed heterogeneity. CONCLUSION: For ruling out CAD, CT is more accurate than MRI. Scanners with more than 16 rows improve sensitivity, as do slowed heart rates. PRIMARY FUNDING SOURCE: None.
Authors: Andrea L Vavere; Gregory G Simon; Richard T George; Carlos E Rochitte; Andrew E Arai; Julie M Miller; Marcello Di Carli; Armin Arbab-Zadeh; Armin A Zadeh; Marc Dewey; Hiroyuki Niinuma; Roger Laham; Frank J Rybicki; Joanne D Schuijf; Narinder Paul; John Hoe; Sachio Kuribyashi; Hajime Sakuma; Cesar Nomura; Tan Swee Yaw; Klaus F Kofoed; Kunihiro Yoshioka; Melvin E Clouse; Jeffrey Brinker; Christopher Cox; Joao A C Lima Journal: J Cardiovasc Comput Tomogr Date: 2011-11-12
Authors: Matthias Rief; Marcus Y Chen; Andrea L Vavere; Benjamin Kendziora; Julie M Miller; W Patricia Bandettini; Christopher Cox; Richard T George; João Lima; Marcelo Di Carli; Michail Plotkin; Elke Zimmermann; Michael Laule; Peter Schlattmann; Andrew E Arai; Marc Dewey Journal: Radiology Date: 2017-09-25 Impact factor: 11.105
Authors: Robert Roehle; Viktoria Wieske; Georg M Schuetz; Pascal Gueret; Daniele Andreini; Willem Bob Meijboom; Gianluca Pontone; Mario Garcia; Hatem Alkadhi; Lily Honoris; Jörg Hausleiter; Nuno Bettencourt; Elke Zimmermann; Sebastian Leschka; Bernhard Gerber; Carlos Rochitte; U Joseph Schoepf; Abbas Arjmand Shabestari; Bjarne Nørgaard; Akira Sato; Juhani Knuuti; Matthijs F L Meijs; Harald Brodoefel; Shona M M Jenkins; Kristian Altern Øvrehus; Axel Cosmus Pyndt Diederichsen; Ashraf Hamdan; Bjørn Arild Halvorsen; Vladimir Mendoza Rodriguez; Yung Liang Wan; Johannes Rixe; Mehraj Sheikh; Christoph Langer; Said Ghostine; Eugenio Martuscelli; Hiroyuki Niinuma; Arthur Scholte; Konstantin Nikolaou; Geir Ulimoen; Zhaoqi Zhang; Hans Mickley; Koen Nieman; Philipp A Kaufmann; Ronny Ralf Buechel; Bernhard A Herzog; Melvin Clouse; David A Halon; Jonathan Leipsic; David Bush; Reda Jakamy; Kai Sun; Lin Yang; Thorsten Johnson; Jean-Pierre Laissy; Roy Marcus; Simone Muraglia; Jean-Claude Tardif; Benjamin Chow; Narinder Paul; David Maintz; John Hoe; Albert de Roos; Robert Haase; Michael Laule; Peter Schlattmann; Marc Dewey Journal: Eur Radiol Date: 2018-03-19 Impact factor: 5.315