MR-IMPACT: comparison of perfusion-cardiac magnetic resonance with single-photon emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trial

Schwitter, Juerg; Wacker, Christian; Rossum, Albert C. van; Lombardi, Massimo; Al-Saadi, Nidal; Åhlström, Håkan; Dill, Thorsten; Larsson, Henrik; Flamm, Scott D.; Marquardt, Moritz; Johansson, Lars

doi:10.1093/eurheartj/ehm617

Cited by 597 publications

(402 citation statements)

References 28 publications

(22 reference statements)

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“…The low prevalence of stress exams in our patient's population highlights an important feature of present registry, which mainly reports activity, performed in radiological units as compared to the prominent clinical/cardiological background of the EuroCMR. This observation accounts the different attitude of cardiologists toward use of stress imaging for the evaluation of CAD and a probably deeper clinical comprehension of the added value of MR in this clinical setting as compared to echocardiography or SPECT [17]. An additional issue to consider in this regard, concerns the extremely variable experience of the centers involved which might have oriented a different pathology focus in less specialized sites in favor of more manageable and easily approachable indications (see Section 7.2).…”

Section: Technical Equipment and Acquisition Protocolsmentioning

confidence: 99%

Italian registry of cardiac magnetic resonance

Francone¹,

Cesare²,

Cademartiri³

et al. 2014

European Journal of Radiology

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Objectives Forty sites were involved in this multicenter and multivendor registry, which sought to evaluate indications, spectrum of protocols, impact on clinical decision making and safety profile of cardiac magnetic resonance (CMR). Materials and methods Data were prospectively collected on a 6-month period and included 3376 patients (47.2 ± 19 years; range 1-92 years). Recruited centers were asked to complete a preliminary general report followed by a single form/patient. Referral physicians were not required to exhibit any specific certificate of competency in CMR imaging. Results Exams were performed with 1.5 T scanners in 96% of cases followed by 3 T (3%) and 1 T (1%) magnets and contrast was administered in 84% of cases. The majority of cases were performed for the workup of inflammatory heart disease/cardiomyopathies representing overall 55.7% of exams followed by the assessment of myocardial viability and acute infarction (respectively 6.9% and 5.9% of patients). In 49% of cases the final diagnosis provided was considered relevant and with impact on patient's clinical/therapeutic management. Safety evaluation revealed 30 (0.88%) clinical events, most of which due to patient's preexisting conditions. Radiological reporting was recorded in 73% of exams. Conclusions CMR is performed in a large number of centers in Italy with relevant impact on clinical decision making and high safety profile. © 2013 Elsevier Ireland Ltd

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Section: Technical Equipment and Acquisition Protocolsmentioning

confidence: 99%

Italian registry of cardiac magnetic resonance

Francone¹,

Cesare²,

Cademartiri³

et al. 2014

European Journal of Radiology

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“…Finally, CMR images were analyzed purely visually using a previously described algorithm [2,[14][15][16]. No semi-quantitative analysis of perfusion-CMR was performed.…”

Section: Limitationsmentioning

confidence: 99%

“…No semi-quantitative analysis of perfusion-CMR was performed. However, most studies investigating the diagnostic accuracy of CMR for the detection of CAD utilize purely visual evaluation [2,[14][15][16]27] and the majority of centers continue to use visual analysis for the assessment of clinical myocardial perfusion scans [28]. Comparing the rest and stress scans together on a viewing platform allows the recognition of perfusion defects and discrimination from artifacts, as previously shown [29].…”

Section: Limitationsmentioning

confidence: 99%

“…Nevertheless, non-invasive imaging modalities including nuclear tests [1], cardiac magnetic resonance imaging (CMR) [2], and computed tomography coronary angiography (CTCA) [3,4] have challenged the role of the invasive standard.…”

Section: Introductionmentioning

confidence: 99%

“…Stress-and rest adenosine first pass perfusion-CMR with late gadolinium-enhancement (LGE) allows for the detection of both ischemic and ischemic myocardium, both indicating the hemodynamic relevance of a coronary stenosis. Various studies have demonstrated a high diagnostic performance of CMR in comparison with CA [2,8,9]. Nevertheless, no study has -to the best of our knowledge -directly compared these two non-invasive imaging modalities, i.e., low-dose CTCA and CMR, with regard to their diagnostic performance in the same patient population.…”

Section: Introductionmentioning

confidence: 99%

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Low-dose CT and cardiac MR for the diagnosis of coronary artery disease: accuracy of single and combined approaches

Scheffel

Stolzmann

Alkadhi

et al. 2010

Int J Cardiovasc Imaging

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Purpose: To prospectively compare the diagnostic performance of low-dose computed tomography coronary angiography (CTCA) and cardiac magnetic resonance imaging (CMR) and combinations thereof for the diagnosis of significant coronary stenoses. Materials and Methods:Forty-three consecutive patients with known or suspected coronary artery disease underwent catheter coronary angiography (CA), dual-source CTCA with prospective electrocardiography-gating, and cardiac CMR (1.5 Tesla).The following tests were analyzed: 1) low-dose CTCA, 2) adenosine stress-rest perfusion-CMR, 3) late gadolinium enhancement (LGE), 4) perfusion-CMR and LGE, 5) low-dose CTCA combined with perfusion-CMR, 5) low-dose CTCA combined with late gadolinium-enhancement, 6) low-dose CTCA combined with perfusion-CMR andLGE. CA served as the standard of reference.Results: CA revealed >50% diameter stenoses in 68/129 (57.7%) coronary arteries in 29/43 (70%) patients. In the patient-based analysis, sensitivity, specificity, NPV and PPV of low-dose CTCA for the detection of significant stenoses were 100%, 92.9%, 100% and 96.7%, respectively. For perfusion-CMR and LGE, sensitivity, specificity, NPV, PPV, and accuracy were 89.7%, 100%, 82.4%, and 100%, respectively. In the artery-based analysis, sensitivity and NPV of low-dose CTCA was significantly (p<0.05) higher than that of perfusion-CMR and LGE. All combinations of low-dose CTCA and perfusion-CMR and/or LGE did not improve the diagnostic performance when compared to low-dose CTCA alone. Conclusion:Taking CA as standard of reference, low-dose CTCA outperforms CMR with regard to sensitivity and NPV, whereas CMR is more specific and has a higher PPV than low-dose CTCA. 4Word count: 245

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Alternatives in the Evaluation of Suspected Coronary Heart Disease

Schwitter

2017

JAMA

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MR-IMPACT: comparison of perfusion-cardiac magnetic resonance with single-photon emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trial

Cited by 597 publications

References 28 publications

Italian registry of cardiac magnetic resonance

Italian registry of cardiac magnetic resonance

Low-dose CT and cardiac MR for the diagnosis of coronary artery disease: accuracy of single and combined approaches

Alternatives in the Evaluation of Suspected Coronary Heart Disease

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