Hybrid myocardial perfusion SPECT/CT coronary angiography and invasive coronary angiography in patients with stable angina pectoris lead to similar treatment decisions. Heart. 2012 Oct 19. [Epub ahead of print]
Diagnostic Accuracy of Cardiac Positron Emission Tomography versus Single Photon Emission Computed Tomography for Coronary Artery Disease: A Bivariate Meta-Analysis. Circ Cardiovasc Imaging. 2012 Oct 10. [Epub ahead of print]Authors: Parker MW, Iskandar A, Limone B, Perugini A, Kim H, Jones C, Calamari B, Coleman CI, Heller GV. Positron emission tomography (PET) myocardial perfusion imaging (MPI) offers technical benefits over single-photon emission computed tomography (SPECT) MPI, but there has been no systematic comparison of their diagnostic accuracy for coronary artery disease. The Authors performed a bivariate meta-analysis of the published literature to compare the sensitivity and specificity of PET versus SPECT stress MPI for ≥50% stenosis of any epicardial coronary artery in patients with known or suspected coronary artery disease (CAD). The Authors searched MEDLINE and EMBASE from inception through January 2012 and the references of identified studies for prospective, English-language studies that evaluated the sensitivity and specificity of PET and/or SPECT MPI with coronary angiography as the reference standard and reported sufficient data to calculate patient-level true and false positives and negatives. Two investigators independently extracted patient and study characteristics; a third investigator resolved any disagreements. The Authors identified 117 studies, including 108 evaluating SPECT MPI, four evaluating PET MPI, and five evaluating both modalities. Bivariate meta-analysis demonstrated a significantly higher pooled mean sensitivity with PET [92.6% (95% Confidence Interval (CI), 88.3% to 95.5%)] compared to SPECT [88.3% (95% CI, 86.4% to 90.0%)] (p=0.035). No significant difference in specificity was observed between PET [81.3% (95% CI, 66.6% - 90.4%)] and SPECT [75.8% (95% CI, 72.1% - 79.1%)] (p=0.39). Few studies investigated coronary angiography with PET. Only five studies directly compared SPECT and PET. Conclusions: In a meta-analysis of 11,862 patients, PET MPI demonstrated a higher sensitivity for CAD than SPECT MPI. No difference in specificity was detected in the pooled analysis of PET and SPECT MPI.
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