RT Journal Article
SR Electronic
T1 Diagnostic Performance of Attenuation-Corrected Myocardial Perfusion Imaging for Coronary Artery Disease: A Systematic Review and Meta-Analysis
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1893
OP 1898
DO 10.2967/jnumed.115.171462
VO 57
IS 12
A1 Jei-Yie Huang
A1 Chun-Kai Huang
A1 Ruoh-Fang Yen
A1 Hon-Yen Wu
A1 Yu-Kang Tu
A1 Mei-Fang Cheng
A1 Ching-Chu Lu
A1 Kai-Yuan Tzen
A1 Kuo-Liong Chien
A1 Yen-Wen Wu
YR 2016
UL http://jnm.snmjournals.org/content/57/12/1893.abstract
AB Myocardial perfusion imaging (MPI) with SPECT is a well-established tool for the diagnosis of coronary artery disease (CAD). However, soft-tissue attenuation is a common artifact that limits the diagnostic accuracy of MPI. The aim of this study was to determine whether attenuation correction (AC) improved the diagnostic performance of MPI, using coronary angiography as a reference standard. Methods: MEDLINE and EMBASE were searched until March 2015 for studies evaluating AC MPI for the diagnosis of CAD. Methodologic quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. For each study, the sensitivity, specificity, and diagnostic odds ratio, along with 95% confidence intervals (CIs), were calculated to determine the diagnostic accuracy of AC versus non–attenuation-corrected (NAC) MPI. A bivariate mixed-effects model was applied for pooling the data. Results: Of 201 articles, 17 studies (1,701 patients) were identified, including 5 studies that used CT AC, 12 studies that used radionuclide source AC (RAC), and 15 studies that reported NAC results. The pooled sensitivities across studies were 0.80 (95% CI, 0.64–0.91), 0.85 (95% CI, 0.81–0.88), 0.84 (95% CI, 0.79–0.88), and 0.80 (95% CI, 0.75–0.85) for CT AC, RAC, all AC, and NAC, respectively. The pooled specificities were 0.83 (95% CI, 0.71–0.91), 0.81 (95% CI, 0.73–0.86), 0.80 (95% CI, 0.74–0.85), and 0.68 (95% CI, 0.61–0.74). Both sensitivities and specificities resulted in a pooled diagnostic odds ratio of 20 (95% CI, 12–34), 24 (95% CI, 13–43), 22 (95% CI, 13–35), and 9 (7–11). Significant differences in specificity and diagnostic odds ratios were noted when AC (including CT AC, RAC, and all AC) was compared with NAC. Conclusion: The results from this study suggested that AC should be applied to MPI to improve the diagnosis of CAD, especially the specificity.