Diagnostic accuracy of static CT perfusion for the detection of myocardial ischemia. A systematic review and meta-analysis

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art_SORGAARD_Diagnostic_accuracy_of_static_CT_perfusion_for_the_2016.PDF (949.56 KB)
Citações na Scopus
43
Tipo de produção
article
Data de publicação
2016
Editora
ELSEVIER SCIENCE INC
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
SORGAARD, Mathias Holm
KOFOED, Klaus Fuglsang
LINDE, Jesper James
GEORGE, Richard Thomas
FEUCHTNER, Gudrun
LIMA, Joao A. C.
ABDULLA, Jawdat
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
Journal of Cardiovascular Computed Tomography, v.10, n.6, p.450-457, 2016
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
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 CFA.
Palavras-chave
Coronary computed tomography angiography, Invasive coronary angiography, Stress myocardial perfusion, Coronary artery disease, Fractional flow reserve, Meta-analysis, Computed tomography perfusion, Single photon emission computed tomography, Magnetic resonance perfusion
URI
https://observatorio.fm.usp.br/handle/OPI/18096
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Coleções
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - ODS/03