Comparison of Magnetic Resonance Perfusion Imaging Versus Invasive Fractional Flow Reserve for Assessment of the Hemodynamic Significance of Epicardial Coronary Artery Stenosis

Kühl, Harald P.; Katoh, Marcus; Buhr, Christiane; Krombach, Gabriele A.; Hoffmann, Rainer; Rassaf, Tienush; Neizel, Mirja; Buecker, Arno; Kelm, Malte

doi:10.1016/j.amjcard.2006.11.061

Cited by 28 publications

(12 citation statements)

References 16 publications

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“…If validated, this may represent a better reference standard than CA alone. However, although three studies found there to be a good correlation between the performance of stress perfusion CMR and CA with FFR measurement [31,33,35], sufficient data was not present to evaluate its accuracy in this study.…”

Section: Discussionmentioning

confidence: 87%

“…In this meta-analysis, 18 studies were based on stress perfusion CMR alone [10-13,15,17,19-21,24,26,31-33,35,37,39,44], whilst the other 17 included a multi-component examination (cine and/or late gadolinium enhancement (LGE) and/or coronary angiography and/or stress tagging) [14,16,18,22,23,25,27-30,34,36,38,40-43]. In their studies, Plein [22], Cury [28] and Klem [29] evaluated the differences in accuracy based on the sequences evaluated and found that all studies increased accuracy when using a combined analysis.…”

Section: Discussionmentioning

confidence: 99%

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Meta-analysis of the diagnostic performance of stress perfusion cardiovascular magnetic resonance for detection of coronary artery disease

Hamon

Fau

Née

et al. 2010

Journal of Cardiovascular Magnetic Resonance

238

120

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AimEvaluation of the diagnostic accuracy of stress perfusion cardiovascular magnetic resonance for the diagnosis of significant obstructive coronary artery disease (CAD) through meta-analysis of the available data.MethodologyOriginal articles in any language published before July 2009 were selected from available databases (MEDLINE, Cochrane Library and BioMedCentral) using the combined search terms of magnetic resonance, perfusion, and coronary angiography; with the exploded term coronary artery disease. Statistical analysis was only performed on studies that: (1) used a [greater than or equal to] 1.5 Tesla MR scanner; (2) employed invasive coronary angiography as the reference standard for diagnosing significant obstructive CAD, defined as a [greater than or equal to] 50% diameter stenosis; and (3) provided sufficient data to permit analysis.ResultsFrom the 263 citations identified, 55 relevant original articles were selected. Only 35 fulfilled all of the inclusion criteria, and of these 26 presented data on patient-based analysis. The overall patient-based analysis demonstrated a sensitivity of 89% (95% CI: 88-91%), and a specificity of 80% (95% CI: 78-83%). Adenosine stress perfusion CMR had better sensitivity than with dipyridamole (90% (88-92%) versus 86% (80-90%), P = 0.022), and a tendency to a better specificity (81% (78-84%) versus 77% (71-82%), P = 0.065).ConclusionStress perfusion CMR is highly sensitive for detection of CAD but its specificity remains moderate.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Meta-analysis of the diagnostic performance of stress perfusion cardiovascular magnetic resonance for detection of coronary artery disease

Hamon

Fau

Née

et al. 2010

Journal of Cardiovascular Magnetic Resonance

238

120

View full text Add to dashboard Cite

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“…Thirty-seven articles (excluding 4 with overlapping patient populations) [12][13][14][15] met our predefined criteria and were selected for inclusion with an inter-rater agreement of κ=0.89. Included studies were published between 1996 and 2014.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic Accuracy of Stress Myocardial Perfusion Imaging Compared to Invasive Coronary Angiography With Fractional Flow Reserve Meta-Analysis

Takx

Blomberg

Aidi

et al. 2015

Circ: Cardiovascular Imaging

347

170

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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.

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“…Perfusion CMR has also been validated against fractional fl ow reserve for the discrimination of relevant from nonrelevant coronary lesions [22][23][24][25].…”

Section: Accuracy In the Diagnosis Of Cadmentioning

confidence: 99%

Assessment of myocardial ischemia and viability using cardiac magnetic resonance

Bettencourt

Chiribiri

Schuster

et al. 2009

Curr Heart Fail Rep

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In the past decade, cardiac magnetic resonance (CMR) has evolved dramatically. Its clinical applications are now a major tool in the diagnosis and prognostic assessment of patients with ischemic heart disease. CMR can be used for detection and quantification of ischemia and for viability assessment using different techniques that are now well validated. Scar can be easily detected using contrast enhancement (late gadolinium enhancement). Ischemia detection is usually achieved with stress CMR techniques, whereas prediction for the recovery of function (detection of dysfunctional but viable myocardial segments) can be deduced from scar and stress imaging. Although determination of which approach is better may depend on the population group, the major advantage of CMR is the ability to integrate different information about anatomy, wall motion, myocardial perfusion, and tissue characterization in a single comprehensive examination.

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Comparison of Magnetic Resonance Perfusion Imaging Versus Invasive Fractional Flow Reserve for Assessment of the Hemodynamic Significance of Epicardial Coronary Artery Stenosis

Cited by 28 publications

References 16 publications

Meta-analysis of the diagnostic performance of stress perfusion cardiovascular magnetic resonance for detection of coronary artery disease

Meta-analysis of the diagnostic performance of stress perfusion cardiovascular magnetic resonance for detection of coronary artery disease

Diagnostic Accuracy of Stress Myocardial Perfusion Imaging Compared to Invasive Coronary Angiography With Fractional Flow Reserve Meta-Analysis

Assessment of myocardial ischemia and viability using cardiac magnetic resonance

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