Response to Letter Regarding Article “Comparison of Cardiovascular Magnetic Resonance and Single-Photon Emission Computed Tomography in Women With Suspected Coronary Artery Disease From the Clinical Evaluation of Magnetic Resonance Imaging in Coronary Heart Disease (CE-MARC) Trial”
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Many of the issues raised by Dr Einstein have been addressed in the article1 and in previous correspondence relating to the Clinical Evaluation of Magnetic Resonance Imaging in Coronary Heart Disease (CE-MARC) study.2,3
Einstein argues that the inclusion of magnetic resonance angiography offered cardiovascular magnetic resonance (CMR) an unfair advantage. However, as discussed in the article, secondary analyses from CE-MARC showed that excluding the magnetic resonance angiography component not only had a neutral effect on overall diagnostic accuracy, but actually led to a superior positive-predictive value for CMR in comparison with single-photon emission computed tomography (SPECT; owing to a reduction in false positives).2 We also included a detailed perfusion-only component analysis that Einstein makes no reference to in his critique. For perfusion-only components, CMR still significantly outperformed SPECT in females (area under the curve, 0.90 versus …