Abstract
Objectives
To compare the diagnostic accuracy of computed tomography (CT) in the assessment of global and regional left ventricular (LV) function with magnetic resonance imaging (MRI).
Methods
MEDLINE, EMBASE and ISI Web of Science were systematically reviewed. Evaluation included: ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and left ventricular mass (LVM). Differences between modalities were analysed using limits of agreement (LoA). Publication bias was measured by Egger’s regression test. Heterogeneity was evaluated using Cochran’s Q test and Higgins I2 statistic. In the presence of heterogeneity the DerSimonian-Laird method was used for estimation of heterogeneity variance.
Results
Fifty-three studies including 1,814 patients were identified. The mean difference between CT and MRI was -0.56 % (LoA, -11.6–10.5 %) for EF, 2.62 ml (-34.1–39.3 ml) for EDV and 1.61 ml (-22.4–25.7 ml) for ESV, 3.21 ml (-21.8–28.3 ml) for SV and 0.13 g (-28.2–28.4 g) for LVM. CT detected wall motion abnormalities on a per-segment basis with 90 % sensitivity and 97 % specificity.
Conclusions
CT is accurate for assessing global LV function parameters but the limits of agreement versus MRI are moderately wide, while wall motion deficits are detected with high accuracy.
Key Points
• CT helps to assess patients with coronary artery disease (CAD).
• MRI is the reference standard for evaluation of left ventricular function.
• CT provides accurate assessment of global left ventricular function.
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Abbreviations
- CAD:
-
Coronary artery disease
- CT:
-
Computed tomography
- EDV:
-
End-diastolic volume
- EF:
-
Ejection fraction
- ESV:
-
End-systolic volume
- LoA:
-
Limits of agreement
- LV:
-
Left ventricular
- LVM:
-
Left ventricular mass
- MRI:
-
Magnetic resonance imaging
- SV:
-
Stroke volume
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Acknowledgements
The scientific guarantor of this publication is Prof. Dewey. The authors of this manuscript declare relationships with the following companies:
Prof. Dewey has received grant support from the Heisenberg Program of the DFG for a professorship (DE 1361/14-1), the FP7 Program of the European Commission for the randomised multicentre DISCHARGE trial (603266-2, HEALTH-2012.2.4.-2), the European Regional Development Fund (20072013 2/05, 20072013 2/48), the German Heart Foundation/German Foundation of Heart Research (F/23/08, F/27/10), the Joint Program of the German Research Foundation (DFG) and the German Federal Ministry of Education and Research (BMBF) for meta-analyses (01KG1013, 01KG1110, 01KG1110), GE Healthcare, Bracco, Guerbet, and Toshiba Medical Systems.
Prof. Dewey has received lecture fees from Toshiba Medical Systems, Guerbet, Cardiac MR Academy Berlin, and Bayer (Schering-Berlex).
Prof. Dewey is a consultant to Guerbet and one of the principal investigators of multicentre studies (CORE-64 and 320) on coronary CT angiography sponsored by Toshiba Medical Systems. He is also the editor of Coronary CT Angiography and Cardiac CT, both published by Springer, and offers hands-on workshops on cardiovascular imaging (www.ct-kurs.de). Prof. Dewey is an associate editor of Radiology and European Radiology.
Prof. Schlattmann received grant support from the tFP7 Program of the European Commission for the randomized multicenter DISCHARGE trial (603266-2, HEALTH-2012.2.4.-2), the Joint Program of the German Research Foundation (DFG) and the German Federal Ministry of Education and Research (BMBF) for meta-analyses (01KG1013, 01KG1110, 01KG1110).
Institutional master research agreements exist with Siemens Medical Solutions, Philips Medical Systems, and Toshiba Medical Systems. The terms of these arrangements are managed by the legal department of Charité – Universitätsmedizin Berlin.
The authors state that this work was supported by the Heisenberg Program of the DFG for a professorship (DE 1361/14-1).Statistical expert: Peter Schlattmann (co-author). Institutional Review Board approval was not necessary. Written informed consent was not necessary. None of the results have been previously reported. Methodology: prospective, meta-analysis, performed at one institution.
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Kaniewska, M., Schuetz, G.M., Willun, S. et al. Noninvasive evaluation of global and regional left ventricular function using computed tomography and magnetic resonance imaging: a meta-analysis. Eur Radiol 27, 1640–1659 (2017). https://doi.org/10.1007/s00330-016-4513-1
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DOI: https://doi.org/10.1007/s00330-016-4513-1