title: Accuracy of multi-slice computed tomography for measurement of left ventricular ejection fraction compared with cardiac magnetic resonance imaging and two-dimensional transthoracic echocardiography: a systematic review and meta-analysis.
abstract: BACKGROUND
  Multi-slice computed tomography (MSCT) allows non-invasive assessment of the coronary arteries and simultaneously can provide measurement of left ventricular ejection fraction (LVEF). The accuracy of newer MSCT generations (64-slice or more) for assessment of LVEF compared with magnetic resonance imaging (MRI) and two-dimensional transthoracic echocardiography (TTE) has not been evaluated in a meta-analysis.
  
  
  OBJECTIVE
  To evaluate, via a systematic literature review and meta-analysis, whether MSCT can assess LVEF with high accuracy compared with MRI and TTE.
  
  
  METHODS
  Electronic databases and reference lists for relevant published studies were searched. Twenty-seven eligible studies provided mean LVEF% with its standard deviation (SD) measured by MSCT versus MRI and TTE. Meta-analysis of weighted mean difference (WMD) and Bland-Altman method were used to quantify the mean difference and agreement between MSCT compared with MRI and TTE.
  
  
  RESULTS
  The results of combining 12 studies showed no significant difference in LVEF% between MSCT and MRI with a WMD of -0.11 (-1.48, 1.26, 95% CI), p=0.88. Bland-Altman analysis showed excellent agreement between MSCT and MRI with a bias of 0.0 (-3.7, 3.7 ± 1.96SD) with 95% CI. The results of combining 15 studies showed no significant difference in LVEF between MSCT versus TTE measurements with a WMD of 0.19 (-1.13 to 1.50; 95% CI), p=0.87. Bland-Altman analysis showed excellent agreement between MSCT and TTE with a bias of 0.3 (-4.7, 5.7 ± 1.96SD) with 95% CI.
  
  
  CONCLUSIONS
  The newer MSCT generations can provide accurate LVEF measurement compared to MRI and TTE. MSCT represents a valid technique for the combined evaluation of LVEF and coronary artery disease.
authors.affiliation: Department of Medicine M2, Division of Cardiology, Copenhagen University Hospital, Nordre Ringvej 57, 2600 Glostrup, Denmark. C.asferg@gmail.com
authors.forename: Camilla
authors.initials: C
authors.lastname: Asferg
authors.forename: Lotte
authors.initials: L
authors.lastname: Usinger
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Kristensen
authors.forename: Jawdat
authors.initials: J
authors.lastname: Abdulla
mesh_terms: D015897:Comorbidity; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology; D004452:Echocardiography / Q000706:statistics & numerical data*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000453:epidemiology