Richard A P Takx1, Björn A Blomberg2, Hamza El Aidi2, Jesse Habets2, Pim A de Jong2, Eike Nagel2, Udo Hoffmann2, Tim Leiner2. 1. From the Departments of Radiology (R.A.P.T., B.A.B., H.E.A., J.H., P.A.d.J., T.L.) and Cardiology (H.E.A.), University Medical Center Utrecht, Utrecht, The Netherlands; Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston (R.A.P.T., U.H.); and Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, London, United Kingdom (E.N.). rtakx@umcutrecht.nl. 2. From the Departments of Radiology (R.A.P.T., B.A.B., H.E.A., J.H., P.A.d.J., T.L.) and Cardiology (H.E.A.), University Medical Center Utrecht, Utrecht, The Netherlands; Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston (R.A.P.T., U.H.); and Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, London, United Kingdom (E.N.).
Abstract
BACKGROUND: Hemodynamically significant coronary artery disease is an important indication for revascularization. Stress myocardial perfusion imaging is a noninvasive alternative to invasive fractional flow reserve for evaluating hemodynamically significant coronary artery disease. The aim was to determine the diagnostic accuracy of myocardial perfusion imaging by single-photon emission computed tomography, echocardiography, MRI, positron emission tomography, and computed tomography compared with invasive coronary angiography with fractional flow reserve for the diagnosis of hemodynamically significant coronary artery disease. METHODS AND RESULTS: The meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. PubMed, EMBASE, and Web of Science were searched until May 2014. Thirty-seven studies, reporting on 4721 vessels and 2048 patients, were included. Meta-analysis yielded pooled sensitivity, pooled specificity, pooled likelihood ratios (LR), pooled diagnostic odds ratio, and summary area under the receiver operating characteristic curve. The negative LR (NLR) was chosen as the primary outcome. At the vessel level, MRI (pooled NLR, 0.16; 95% confidence interval [CI], 0.13-0.21) was performed similar to computed tomography (pooled NLR, 0.22; 95% CI, 0.12-0.39) and positron emission tomography (pooled NLR, 0.15; 95% CI, 0.05-0.44), and better than single-photon emission computed tomography (pooled NLR, 0.47; 95% CI, 0.37-0.59). At the patient level, MRI (pooled NLR, 0.14; 95% CI, 0.10-0.18) performed similar to computed tomography (pooled NLR, 0.12; 95% CI, 0.04-0.33) and positron emission tomography (pooled NLR, 0.14; 95% CI, 0.02-0.87), and better than single-photon emission computed tomography (pooled NLR, 0.39; 95% CI, 0.27-0.55) and echocardiography (pooled NLR, 0.42; 95% CI, 0.30-0.59). CONCLUSIONS: Stress myocardial perfusion imaging with MRI, computed tomography, or positron emission tomography can accurately rule out hemodynamically significant coronary artery disease and can act as a gatekeeper for invasive revascularization. Single-photon emission computed tomography and echocardiography are less suited for this purpose.
BACKGROUND: Hemodynamically significant coronary artery disease is an important indication for revascularization. Stress myocardial perfusion imaging is a noninvasive alternative to invasive fractional flow reserve for evaluating hemodynamically significant coronary artery disease. The aim was to determine the diagnostic accuracy of myocardial perfusion imaging by single-photon emission computed tomography, echocardiography, MRI, positron emission tomography, and computed tomography compared with invasive coronary angiography with fractional flow reserve for the diagnosis of hemodynamically significant coronary artery disease. METHODS AND RESULTS: The meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. PubMed, EMBASE, and Web of Science were searched until May 2014. Thirty-seven studies, reporting on 4721 vessels and 2048 patients, were included. Meta-analysis yielded pooled sensitivity, pooled specificity, pooled likelihood ratios (LR), pooled diagnostic odds ratio, and summary area under the receiver operating characteristic curve. The negative LR (NLR) was chosen as the primary outcome. At the vessel level, MRI (pooled NLR, 0.16; 95% confidence interval [CI], 0.13-0.21) was performed similar to computed tomography (pooled NLR, 0.22; 95% CI, 0.12-0.39) and positron emission tomography (pooled NLR, 0.15; 95% CI, 0.05-0.44), and better than single-photon emission computed tomography (pooled NLR, 0.47; 95% CI, 0.37-0.59). At the patient level, MRI (pooled NLR, 0.14; 95% CI, 0.10-0.18) performed similar to computed tomography (pooled NLR, 0.12; 95% CI, 0.04-0.33) and positron emission tomography (pooled NLR, 0.14; 95% CI, 0.02-0.87), and better than single-photon emission computed tomography (pooled NLR, 0.39; 95% CI, 0.27-0.55) and echocardiography (pooled NLR, 0.42; 95% CI, 0.30-0.59). CONCLUSIONS:Stress myocardial perfusion imaging with MRI, computed tomography, or positron emission tomography can accurately rule out hemodynamically significant coronary artery disease and can act as a gatekeeper for invasive revascularization. Single-photon emission computed tomography and echocardiography are less suited for this purpose.
Authors: Akhil Narang; John E Blair; Mita B Patel; Victor Mor-Avi; Savitri E Fedson; Nir Uriel; Roberto M Lang; Amit R Patel Journal: Int J Cardiovasc Imaging Date: 2018-05-04 Impact factor: 2.357
Authors: Stacey Knight; David B Min; Viet T Le; Kent G Meredith; Ritesh Dhar; Santanu Biswas; Kurt R Jensen; Steven M Mason; Jon-David Ethington; Donald L Lappe; Joseph B Muhlestein; Jeffrey L Anderson; Kirk U Knowlton Journal: JCI Insight Date: 2018-05-03
Authors: Arthur E Stillman; Matthijs Oudkerk; David A Bluemke; Menko Jan de Boer; Jens Bremerich; Ernest V Garcia; Matthias Gutberlet; Pim van der Harst; W Gregory Hundley; Michael Jerosch-Herold; Dirkjan Kuijpers; Raymond Y Kwong; Eike Nagel; Stamatios Lerakis; John Oshinski; Jean-François Paul; Riemer H J A Slart; Vinod Thourani; Rozemarijn Vliegenthart; Bernd J Wintersperger Journal: Int J Cardiovasc Imaging Date: 2018-03-19 Impact factor: 2.357
Authors: V-M Sundell; M Kortesniemi; T Siiskonen; A Kosunen; S Rosendahl; L Büermann Journal: Radiat Prot Dosimetry Date: 2021-01-15 Impact factor: 0.972