title: Direct comparison of cardiovascular magnetic resonance and single-photon emission computed tomography for detection of coronary artery disease: a meta-analysis.
abstract: OBJECTIVE
  To use direct comparative studies or randomised controlled trials to compare the accuracy of cardiac magnetic resonance (CMR) and single-photon emission computed tomography (SPECT) for the detection of obstructive coronary artery disease (CAD).
  
  
  METHODS
  Various databases were searched for original articles published prior to June 2013. Studies were selected that performed both CMR and SPECT in the same or randomised patients to detect CAD and that presented sufficient data to allow construction of contingency tables. For each study, the true-positive, false-positive, true-negative, and false-negative values were extracted or derived, and 2 × 2 contingency tables were constructed. To reduce heterogeneity, the meta-analysis was carried out in two parts: (1) coronary territory-based analysis and (2) patient-based analysis.
  
  
  RESULTS
  10 studies (5 studies based on patient, 4 studies based on coronary territory, and 1 study based on both) were included in the meta-analysis with a total of 1727 patients. The methodological quality was moderate. For part (1), the summary estimates were as follows: for CMR based on patient-a sensitivity of 0.79 (95% confidence interval: 0.72-0.84) and a specificity of 0.75 (0.65-0.83); for SPECT based on patient-a sensitivity of 0.70 (0.59-0.79) and a specificity of 0.76 (0.66-0.83). For part (2), the summary estimates for CMR based on coronary territory were a sensitivity of 0.80 (0.73-0.85) and a specificity of 0.87 (0.81-0.91), and the summary estimates for SPECT based on coronary territory were a sensitivity of 0.67 (0.60-0.72) and a specificity of 0.80 (0.75-0.84).
  
  
  CONCLUSIONS
  Compared with SPECT, CMR is more sensitive to detect CAD on a per-patient basis. Nonetheless, large scale, well-designed trials are necessary to assess its clinical value on a per-coronary territory basis.
authors: Department of Radiology, Taihu Hospital, Wuxi, Jiangsu Province, China.
authors: Lihua
authors: L
authors: Chen
authors: Department of Cardiology, Taihu Hospital, Wuxi, Jiangsu Province, China.
authors: Xiao
authors: X
authors: Wang
authors: Molecular biology lab, Wuxi center for disease control and prevention, Wuxi, Jiangsu Province, China.
authors: Jing
authors: J
authors: Bao
authors: Department of Radiology, Taihu Hospital, Wuxi, Jiangsu Province, China.
authors: Chengjun
authors: C
authors: Geng
authors: Department of Radiology, Taihu Hospital, Wuxi, Jiangsu Province, China.
authors: Yunbao
authors: Y
authors: Xia
authors: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors: Jian
authors: J
authors: Wang
mesh_terms: D000328:Adult; D016001:Confidence Intervals; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D006801:Humans; D018810:Magnetic Resonance Angiography; D017594:Publication Bias; D012372:ROC Curve; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon