Diagnostic Performance of Hybrid Cardiac Imaging Methods for Assessment of Obstructive Coronary Artery Disease Compared With Stand-Alone Coronary Computed Tomography Angiography: A Meta-Analysis

Asim Rizvi, Donghee Han, Ibrahim Danad, Bríain Ó Hartaigh, Ji Hyun Lee, Heidi Gransar, Wijnand J. Stuijfzand, Hadi Mirhedayati Roudsari, Mahn Won Park, Jackie Szymonifka, Hyuk Jae Chang, Erica C. Jones, Paul Knaapen, Fay Y. Lin, James K. Min, Jessica M. Peña

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives: The current meta-analysis aimed to evaluate the diagnostic performance of hybrid cardiac imaging techniques compared with stand-alone coronary computed tomography angiography (CTA) for assessment of obstructive coronary artery disease (CAD). Background: The usefulness of coronary CTA for detecting obstructive CAD remains suboptimal at present. Myocardial perfusion imaging encompasses positron emission tomography, single-photon emission computed tomography, and cardiac magnetic resonance, which permit the identification of myocardial perfusion defects to detect significant CAD. A hybrid approach comprising myocardial perfusion imaging and coronary CTA may improve diagnostic performance for detecting obstructive CAD. Methods: PubMed and Web of Knowledge were searched for relevant publications between January 1, 2000 and December 31, 2015. Studies using coronary CTA and hybrid imaging for diagnosis of obstructive CAD (a luminal diameter reduction of >50% or >70% by invasive coronary angiography) were included. In total, 12 articles comprising 951 patients and 1,973 vessels were identified, and a meta-analysis was performed to determine pooled sensitivity, specificity, and summary receiver-operating characteristic curves. Results: On a per-patient basis, the pooled sensitivity of hybrid imaging was comparable to that of coronary CTA (91% vs. 90%; p = 0.28). However, specificity was higher for hybrid imaging versus coronary CTA (93% vs. 66%; p < 0.001). On a per-vessel basis, sensitivity for hybrid imaging against coronary CTA was comparable (84% vs. 89%; p = 0.29). Notably, hybrid imaging yielded a specificity of 95% versus 83% for coronary CTA (p < 0.001). Summary receiver-operating characteristic curves displayed improved discrimination for hybrid imaging beyond coronary CTA alone, on a per-vessel basis (area under the curve: 0.97 vs. 0.93; p = 0.047), although not on a per-patient level (area under the curve: 0.97 vs. 0.93; p = 0.132). Conclusions: Hybrid cardiac imaging demonstrated improved diagnostic specificity for detection of obstructive CAD compared with stand-alone coronary CTA, yet improvement in overall diagnostic performance was relatively limited.

Original languageEnglish
Pages (from-to)589-599
Number of pages11
JournalJACC: Cardiovascular Imaging
Volume11
Issue number4
DOIs
Publication statusPublished - 2018 Apr

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Multimodal Imaging
Meta-Analysis
Coronary Artery Disease
Myocardial Perfusion Imaging
ROC Curve
Area Under Curve
Cardiac Imaging Techniques
Computed Tomography Angiography
Single-Photon Emission-Computed Tomography
Coronary Angiography
PubMed
Positron-Emission Tomography
Publications
Magnetic Resonance Spectroscopy
Perfusion

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Rizvi, Asim ; Han, Donghee ; Danad, Ibrahim ; Ó Hartaigh, Bríain ; Lee, Ji Hyun ; Gransar, Heidi ; Stuijfzand, Wijnand J. ; Roudsari, Hadi Mirhedayati ; Park, Mahn Won ; Szymonifka, Jackie ; Chang, Hyuk Jae ; Jones, Erica C. ; Knaapen, Paul ; Lin, Fay Y. ; Min, James K. ; Peña, Jessica M. / Diagnostic Performance of Hybrid Cardiac Imaging Methods for Assessment of Obstructive Coronary Artery Disease Compared With Stand-Alone Coronary Computed Tomography Angiography : A Meta-Analysis. In: JACC: Cardiovascular Imaging. 2018 ; Vol. 11, No. 4. pp. 589-599.
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abstract = "Objectives: The current meta-analysis aimed to evaluate the diagnostic performance of hybrid cardiac imaging techniques compared with stand-alone coronary computed tomography angiography (CTA) for assessment of obstructive coronary artery disease (CAD). Background: The usefulness of coronary CTA for detecting obstructive CAD remains suboptimal at present. Myocardial perfusion imaging encompasses positron emission tomography, single-photon emission computed tomography, and cardiac magnetic resonance, which permit the identification of myocardial perfusion defects to detect significant CAD. A hybrid approach comprising myocardial perfusion imaging and coronary CTA may improve diagnostic performance for detecting obstructive CAD. Methods: PubMed and Web of Knowledge were searched for relevant publications between January 1, 2000 and December 31, 2015. Studies using coronary CTA and hybrid imaging for diagnosis of obstructive CAD (a luminal diameter reduction of >50{\%} or >70{\%} by invasive coronary angiography) were included. In total, 12 articles comprising 951 patients and 1,973 vessels were identified, and a meta-analysis was performed to determine pooled sensitivity, specificity, and summary receiver-operating characteristic curves. Results: On a per-patient basis, the pooled sensitivity of hybrid imaging was comparable to that of coronary CTA (91{\%} vs. 90{\%}; p = 0.28). However, specificity was higher for hybrid imaging versus coronary CTA (93{\%} vs. 66{\%}; p < 0.001). On a per-vessel basis, sensitivity for hybrid imaging against coronary CTA was comparable (84{\%} vs. 89{\%}; p = 0.29). Notably, hybrid imaging yielded a specificity of 95{\%} versus 83{\%} for coronary CTA (p < 0.001). Summary receiver-operating characteristic curves displayed improved discrimination for hybrid imaging beyond coronary CTA alone, on a per-vessel basis (area under the curve: 0.97 vs. 0.93; p = 0.047), although not on a per-patient level (area under the curve: 0.97 vs. 0.93; p = 0.132). Conclusions: Hybrid cardiac imaging demonstrated improved diagnostic specificity for detection of obstructive CAD compared with stand-alone coronary CTA, yet improvement in overall diagnostic performance was relatively limited.",
author = "Asim Rizvi and Donghee Han and Ibrahim Danad and {{\'O} Hartaigh}, Br{\'i}ain and Lee, {Ji Hyun} and Heidi Gransar and Stuijfzand, {Wijnand J.} and Roudsari, {Hadi Mirhedayati} and Park, {Mahn Won} and Jackie Szymonifka and Chang, {Hyuk Jae} and Jones, {Erica C.} and Paul Knaapen and Lin, {Fay Y.} and Min, {James K.} and Pe{\~n}a, {Jessica M.}",
year = "2018",
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language = "English",
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Rizvi, A, Han, D, Danad, I, Ó Hartaigh, B, Lee, JH, Gransar, H, Stuijfzand, WJ, Roudsari, HM, Park, MW, Szymonifka, J, Chang, HJ, Jones, EC, Knaapen, P, Lin, FY, Min, JK & Peña, JM 2018, 'Diagnostic Performance of Hybrid Cardiac Imaging Methods for Assessment of Obstructive Coronary Artery Disease Compared With Stand-Alone Coronary Computed Tomography Angiography: A Meta-Analysis', JACC: Cardiovascular Imaging, vol. 11, no. 4, pp. 589-599. https://doi.org/10.1016/j.jcmg.2017.05.020

Diagnostic Performance of Hybrid Cardiac Imaging Methods for Assessment of Obstructive Coronary Artery Disease Compared With Stand-Alone Coronary Computed Tomography Angiography : A Meta-Analysis. / Rizvi, Asim; Han, Donghee; Danad, Ibrahim; Ó Hartaigh, Bríain; Lee, Ji Hyun; Gransar, Heidi; Stuijfzand, Wijnand J.; Roudsari, Hadi Mirhedayati; Park, Mahn Won; Szymonifka, Jackie; Chang, Hyuk Jae; Jones, Erica C.; Knaapen, Paul; Lin, Fay Y.; Min, James K.; Peña, Jessica M.

In: JACC: Cardiovascular Imaging, Vol. 11, No. 4, 04.2018, p. 589-599.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Diagnostic Performance of Hybrid Cardiac Imaging Methods for Assessment of Obstructive Coronary Artery Disease Compared With Stand-Alone Coronary Computed Tomography Angiography

T2 - A Meta-Analysis

AU - Rizvi, Asim

AU - Han, Donghee

AU - Danad, Ibrahim

AU - Ó Hartaigh, Bríain

AU - Lee, Ji Hyun

AU - Gransar, Heidi

AU - Stuijfzand, Wijnand J.

AU - Roudsari, Hadi Mirhedayati

AU - Park, Mahn Won

AU - Szymonifka, Jackie

AU - Chang, Hyuk Jae

AU - Jones, Erica C.

AU - Knaapen, Paul

AU - Lin, Fay Y.

AU - Min, James K.

AU - Peña, Jessica M.

PY - 2018/4

Y1 - 2018/4

N2 - Objectives: The current meta-analysis aimed to evaluate the diagnostic performance of hybrid cardiac imaging techniques compared with stand-alone coronary computed tomography angiography (CTA) for assessment of obstructive coronary artery disease (CAD). Background: The usefulness of coronary CTA for detecting obstructive CAD remains suboptimal at present. Myocardial perfusion imaging encompasses positron emission tomography, single-photon emission computed tomography, and cardiac magnetic resonance, which permit the identification of myocardial perfusion defects to detect significant CAD. A hybrid approach comprising myocardial perfusion imaging and coronary CTA may improve diagnostic performance for detecting obstructive CAD. Methods: PubMed and Web of Knowledge were searched for relevant publications between January 1, 2000 and December 31, 2015. Studies using coronary CTA and hybrid imaging for diagnosis of obstructive CAD (a luminal diameter reduction of >50% or >70% by invasive coronary angiography) were included. In total, 12 articles comprising 951 patients and 1,973 vessels were identified, and a meta-analysis was performed to determine pooled sensitivity, specificity, and summary receiver-operating characteristic curves. Results: On a per-patient basis, the pooled sensitivity of hybrid imaging was comparable to that of coronary CTA (91% vs. 90%; p = 0.28). However, specificity was higher for hybrid imaging versus coronary CTA (93% vs. 66%; p < 0.001). On a per-vessel basis, sensitivity for hybrid imaging against coronary CTA was comparable (84% vs. 89%; p = 0.29). Notably, hybrid imaging yielded a specificity of 95% versus 83% for coronary CTA (p < 0.001). Summary receiver-operating characteristic curves displayed improved discrimination for hybrid imaging beyond coronary CTA alone, on a per-vessel basis (area under the curve: 0.97 vs. 0.93; p = 0.047), although not on a per-patient level (area under the curve: 0.97 vs. 0.93; p = 0.132). Conclusions: Hybrid cardiac imaging demonstrated improved diagnostic specificity for detection of obstructive CAD compared with stand-alone coronary CTA, yet improvement in overall diagnostic performance was relatively limited.

AB - Objectives: The current meta-analysis aimed to evaluate the diagnostic performance of hybrid cardiac imaging techniques compared with stand-alone coronary computed tomography angiography (CTA) for assessment of obstructive coronary artery disease (CAD). Background: The usefulness of coronary CTA for detecting obstructive CAD remains suboptimal at present. Myocardial perfusion imaging encompasses positron emission tomography, single-photon emission computed tomography, and cardiac magnetic resonance, which permit the identification of myocardial perfusion defects to detect significant CAD. A hybrid approach comprising myocardial perfusion imaging and coronary CTA may improve diagnostic performance for detecting obstructive CAD. Methods: PubMed and Web of Knowledge were searched for relevant publications between January 1, 2000 and December 31, 2015. Studies using coronary CTA and hybrid imaging for diagnosis of obstructive CAD (a luminal diameter reduction of >50% or >70% by invasive coronary angiography) were included. In total, 12 articles comprising 951 patients and 1,973 vessels were identified, and a meta-analysis was performed to determine pooled sensitivity, specificity, and summary receiver-operating characteristic curves. Results: On a per-patient basis, the pooled sensitivity of hybrid imaging was comparable to that of coronary CTA (91% vs. 90%; p = 0.28). However, specificity was higher for hybrid imaging versus coronary CTA (93% vs. 66%; p < 0.001). On a per-vessel basis, sensitivity for hybrid imaging against coronary CTA was comparable (84% vs. 89%; p = 0.29). Notably, hybrid imaging yielded a specificity of 95% versus 83% for coronary CTA (p < 0.001). Summary receiver-operating characteristic curves displayed improved discrimination for hybrid imaging beyond coronary CTA alone, on a per-vessel basis (area under the curve: 0.97 vs. 0.93; p = 0.047), although not on a per-patient level (area under the curve: 0.97 vs. 0.93; p = 0.132). Conclusions: Hybrid cardiac imaging demonstrated improved diagnostic specificity for detection of obstructive CAD compared with stand-alone coronary CTA, yet improvement in overall diagnostic performance was relatively limited.

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