Diagnostic accuracy of static CT perfusion for the detection of myocardial ischemia: A systematic review and meta-analysis
Research output: Contribution to journal › Journal article › Research › peer-review
OBJECTIVES: The aim of this study is to provide a meta-analysis of all published studies assessing the diagnostic accuracy of stress CT myocardial perfusion imaging (CTP) in patients suspected of or with known coronary artery disease. This analysis is limited to static stress CTP.
METHODS: Systematic literature review and meta-analysis of studies examining the diagnostic accuracy of static CTP imaging alone or combined with coronary CT angiography (CTA) in comparison to single photon emission computed tomography (SPECT), magnetic resonance perfusion (MRP), and/or invasive coronary angiography with and without fractional flow reserve (FFR).
RESULTS: The search revealed 19 eligible studies including 1188 patients. Pooled results showed that CTP had a good agreement with SPECT and MRP. On a per-patient level, sensitivity, specificity and AUC were 0.85 (95% CI: 0.70-0.93), 0.81 (95% CI: 0.59-0.93), 0.90 (95% CI: 0.87-0.92). On a per-artery level, sensitivity, specificity and AUC were 0.80 (95% CI: 0.67-0.88), 0.81 (95% CI: 0.72-0.88) and 0.87 (95% CI: 0.84-0.90). When invasive coronary angiography was used as reference standard, combined coronary CTA and CTP compared to coronary CTA alone significantly improved the specificity from 0.62 (95% CI: 0.52-0.70) to 0.84 (95% CI: 0.74-0.91) on a per-patient level (p = 0.008) and from 0.72 (95% CI: 0.63-0.79) to 0.90 (95% CI: 0.85-0.93) on a per-artery level (p = 0.0001) without significant decrease in sensitivity (p = 0.59 and p = 0.23, respectively).
CONCLUSION: In selected patients, static CT myocardial perfusion has high diagnostic accuracy to detecting myocardial ischemia. Specificity increases significantly when CT myocardial perfusion is combined with coronary CTA.
Original language | English |
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Journal | Journal of Cardiovascular Computed Tomography |
Volume | 10 |
Issue number | 6 |
Pages (from-to) | 450-457 |
Number of pages | 8 |
ISSN | 1934-5925 |
DOIs | |
Publication status | Published - 2016 |
- Aged, Area Under Curve, Computed Tomography Angiography, Coronary Angiography, Coronary Circulation, Coronary Vessels, Female, Humans, Male, Middle Aged, Multidetector Computed Tomography, Myocardial Ischemia, Myocardial Perfusion Imaging, Predictive Value of Tests, ROC Curve, Reproducibility of Results, Journal Article, Meta-Analysis, Review
Research areas
ID: 176952690