Abstract 15130: Diagnostic Performance of Hybrid Cardiac Imaging Methods for Assessment of Significant Coronary Artery Disease Compared With Stand-Alone Coronary Computed Tomography Angiography: A Meta-Analysis
Introduction: The usefulness of coronary CT angiography (CCTA) for detecting significant CAD remains suboptimal at present. Myocardial perfusion imaging (MPI) encompasses positron emission tomography, single photon-emission CT, and cardiac magnetic resonance imaging, which permit for the identification of myocardial perfusion defects to detect CAD. A hybrid approach comprising MPI and CCTA may improve diagnostic performance for detecting significant CAD.
Hypothesis: In a meta-analysis, we aimed to assess the diagnostic performance of hybrid imaging techniques compared with CCTA alone for assessment of significant CAD.
Methods: PubMed and Web of Knowledge were searched for relevant publications between January 1, 2000 and December 31, 2015. Studies performing hybrid imaging and CCTA for diagnosis of significant CAD (a diameter reduction of >50% or >70% by invasive coronary angiography) were included. In total, 13 articles comprising 1,029 patients and 2,339 vessels were identified, and a meta-analysis was performed to estimate pooled sensitivity, specificity, and summary receiver operating characteristic (SROC) curves.
Results: On a per-patient basis, the pooled sensitivity of hybrid imaging was higher than CCTA [91% (95% CI: 88-93%) vs. 89% (95% CI: 86-92%)]. Similarly, specificity was higher for hybrid imaging versus CCTA [92% (95% CI: 89-94% vs. 64% (95% CI: 60-69%)]. On a per-vessel basis, sensitivity for hybrid imaging against CCTA was comparable [85% (95% CI: 82-88%) vs. 87% (95% CI: 84-90%)]. Notably, hybrid imaging yielded a specificity of 95% (95% CI: 94-96%) versus 84% (95% CI: 82-85%) for CCTA. SROC curves displayed improved discrimination for hybrid imaging beyond CCTA alone, on a per-patient (e.g., AUC = 0.97 vs. 0.92) and per-vessel (e.g., AUC = 0.97 vs. 0.93) basis, respectively.
Conclusions: Hybrid cardiac imaging demonstrated improved diagnostic performance for identifying significant CAD compared with stand-alone CCTA.
Author Disclosures: A. Rizvi: None. D. Han: None. I. Danad: None. B. Ó Hartaigh: None. J. Lee: None. J. Szymonifka: None. P. Knaapen: None. F.Y. Lin: None. J.K. Min: Research Grant; Modest; GE Healthcare, NIH/NHLBI R01 HL118019, NIH/NHLBI R01 HL115150, NIH/NHLBI R01 HL111141, NIH/NHLBI U01 HL105907, QNRF NPR-370-3-089. Ownership Interest; Modest; Autoplaq, MDDX. Consultant/Advisory Board; Modest; HeartFlow. Other; Modest; Arineta.
- © 2016 by American Heart Association, Inc.