Oral Abstract Session
SCMR 22nd Annual Scientific Sessions
Kai Yang, MD
No.167, Beilishi Road, Xicheng District, Beijing
Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
Shihua Zhao, MD
Head of the CMR center
Fuwai Hospital, State Key Laboratory of Cardiovascular Disease，National Center for Cardiovascular Diseases， Chinese Academy of Medical Sciences and Peking Union Medical College
Background: Noninvasive myocardial perfusion imaging modalities, such as CMR, SPECT and PET, are increasingly being performed to detect hemodynamically significant coronary artery disease (CAD), guide therapy, and provide prognostic information.This study aimed to determine the diagnostic accuracy of these three most commonly used stress myocardial perfusion imaging for the diagnosis of hemodynamically significant CAD with fractional flow reserve (FFR) as the reference standard.
We searched PubMed and Embase for all published studies that evaluated the diagnostic accuracy of stress myocardial perfusion imaging modalities, including CMR, SPECT, and PET, to diagnose hemodynamically significant CAD with FFR as the reference standard. A study was included if it met the inclusion criteria and MIDAS module was used to perform the analysis using Stata version 14.0 (college station, Texas, USA).
A total of 28 articles met the inclusion criteria and were included in the meta-analysis: 14 CMR, 13 SPECT, and 5 PET articles. The results demonstrated a pooled sensitivity of 0.88 (95% confidence interval [CI]: 0.80-0.93), 0.69 (95% CI: 0.56-0.79), and 0.83 (95% CI: 0.70-0.92), and a pooled specificity of 0.89 (95% CI: 0.85-0.93), 0.85 (95% CI: 0.80-0.89), and 0.87 (95% CI: 0.83-0.90) for CMR, SPECT, and PET, respectively. The area under the curve (AUC) of CMR, PET, and SPECT was 0.94 (95% CI: 0.92-0.96), 0.91 (95% CI: 0.88-0.93), and 0.87 (95% CI: 0.83-0.89), respectively.
Among CMR, SPECT, and PET, with FFR as the reference standard, CMR had the highest diagnostic accuracy to detect hemodynamically significant CAD, and the diagnostic accuracy at 3.0T was superior to 1.5T. Besides, in patients with multivessel disease, the overall diagnostic accuracy of CMR was better than that of SPECT, but this need further validation in the same patient population.