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Diagnostic performance of myocardial perfusion imaging with conventional and CZT single-photon emission computed tomography in detecting coronary artery disease: A meta-analysis

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

We performed a meta-analysis to compare the diagnostic performance of conventional SPECT (C-SPECT) and cadmium-zinc-telluride (CZT)-SPECT systems in detecting angiographically proven coronary artery disease (CAD).

Methods

Studies published between January 2000 and February 2018 were identified by database search. We included studies assessing C-SPECT or CZT-SPECT as a diagnostic test to evaluate patients for the presence of CAD, defined as at least 50% diameter stenosis on invasive coronary angiography. A study was eligible regardless of whether patients were referred for suspected or known CAD.

Results

We identified 40 eligible articles (25 C-SPECT and 15 CZT-SPECT studies) including 7334 patients (4997 in C-SPECT and 2337 in CZT-SPECT studies). The pooled sensitivity and specificity were 85% and 66% for C-SPECT and 89% and 69% for CZT-SPECT imaging studies. The area under the curve was slightly higher for CZT-SPECT (0.89) compared to C-SPECT (0.83); accordingly, the summary diagnostic OR was 17 for CZT-SPECT and 11 for C-SPECT. The accuracy of the two tests slightly differs between C-SPECT and CZT-SPECT (chi-square 11.28, P < .05). At meta-regression analysis, no significant association between both sensitivity and specificity and demographical and clinical variables considered was found for C-SPECT and CZT-SPECT studies.

Conclusions

C-SPECT and CZT-SPECT have good diagnostic performance in detecting angiographic proven CAD, with a slightly higher accuracy for CZT-SPECT. This result supports the use of the novel gamma cameras in clinical routine practices also considering the improvements in acquisition time and radiation exposure reduction.

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Abbreviations

CAD:

Coronary artery disease

MPI:

Myocardial perfusion imaging

SPECT:

Single-photon emission computed tomography

C:

Conventional

CZT:

Cadmium-zinc-telluride

OR:

Odds ratio

CI:

Confidence interval

ROC:

Receiver operator characteristic

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Disclosure

R Green, V. Cantoni, W. Acampa, E. Zampella, R. Assante, C. Nappi, V. Gaudieri, T. Mannarino, R. Cuocolo, E. Di Vaia, M. Petretta, A. Cuocolo declare that they have no conflict of interest.

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  1. Valeria Cantoni and Roberta Green are the first two authors shared first co-authorship.

Authors and Affiliations

  1. Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy

    Valeria Cantoni PhD, Roberta Green PhD, Wanda Acampa MD, PhD, Emilia Zampella MD, PhD, Roberta Assante MD, PhD, Carmela Nappi MD, PhD, Valeria Gaudieri MD, PhD, Teresa Mannarino MD, Renato Cuocolo MD, Eugenio Di Vaia MD & Alberto Cuocolo MD

  2. Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy

    Wanda Acampa MD, PhD

  3. Department of Translational Medical Sciences, University Federico II, Naples, Italy

    Mario Petretta MD, FAHA

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  1. Valeria Cantoni PhD
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Cantoni, V., Green, R., Acampa, W. et al. Diagnostic performance of myocardial perfusion imaging with conventional and CZT single-photon emission computed tomography in detecting coronary artery disease: A meta-analysis. J. Nucl. Cardiol. 28, 698–715 (2021). https://doi.org/10.1007/s12350-019-01747-3

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