Direct Comparison of Cardiovascular Magnetic Resonance and Single-Photon Emission Computed Tomography for Detection of Coronary Artery Disease: A Meta-Analysis

Abstract

ObjectiveTo use direct comparative studies or randomised controlled trials to compare the accuracy of cardiac magnetic resonance (CMR) and single-photon emission computed tomography (SPECT) for the detection of obstructive coronary artery disease (CAD).Materials and MethodsVarious databases were searched for original articles published prior to June 2013. Studies were selected that performed both CMR and SPECT in the same or randomised patients to detect CAD and that presented sufficient data to allow construction of contingency tables. For each study, the true-positive, false-positive, true-negative, and false-negative values were extracted or derived, and 2×2 contingency tables were constructed. To reduce heterogeneity, the meta-analysis was carried out in two parts: (1) coronary territory-based analysis and (2) patient-based analysis.Results10 studies (5 studies based on patient, 4 studies based on coronary territory, and 1 study based on both) were included in the meta-analysis with a total of 1727 patients. The methodological quality was moderate. For part (1), the summary estimates were as follows: for CMR based on patient–a sensitivity of 0.79 (95% confidence interval: 0.72–0.84) and a specificity of 0.75 (0.65–0.83); for SPECT based on patient–a sensitivity of 0.70 (0.59–0.79) and a specificity of 0.76 (0.66–0.83). For part (2), the summary estimates for CMR based on coronary territory were a sensitivity of 0.80 (0.73–0.85) and a specificity of 0.87 (0.81–0.91), and the summary estimates for SPECT based on coronary territory were a sensitivity of 0.67 (0.60–0.72) and a specificity of 0.80 (0.75–0.84).ConclusionsCompared with SPECT, CMR is more sensitive to detect CAD on a per-patient basis. Nonetheless, large scale, well-designed trials are necessary to assess its clinical value on a per-coronary territory basis.

Umbrella review and multivariate meta-analysis of diagnostic test accuracy studies on hybrid non-invasive imaging for coronary artery disease

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Functional imaging for chest pain in the emergency room: To do or not to do?

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“…Robust tort reforms will allow more appropriate testing without fear of the 'unknown.' ; B-F are based on summary sensitivity and specificity from meta-analysis by Chen et al 3 Prevalence of CAD corresponding to 50 % PPV for abnormal stress test is highlighted.…”

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