title: SPECT myocardial perfusion versus fractional flow reserve for evaluation of functional ischemia: a meta analysis.
abstract: OBJECTIVE
  The present meta-analysis illustrates the accuracy of myocardial perfusion SPECT (MPS) to diagnose functional stenotic coronary artery disease (CAD) with fractional flow reserve (FFR) as standard reference.
  
  
  METHODS
  All investigators screened and selected studies that compared MPS with FFR in symptomatic patients with suspected CAD. Patients and study characteristics were independently extracted by two investigators; differences were resolved by consensus.
  
  
  RESULTS
  13 articles, including 1,017 patients, 699 vessels were included in the study. No significant publication bias was detected (P=0.65). At the patient level, the summary sensitivity and specificity were 77% (95% confidence interval [CI], 70-83%) and 77% (95%CI, 67-84%) for MPS. Vessel-level pooled sensitivity was 66% (95%CI, 57-74%) and specificity was 81% (95%CI, 70-89%). The overall diagnostic performance of MPS was moderate. [The area under the summary receiver operating characteristic (sROC) curve was 0.83]. No study influenced the pooled results larger than 0.03.
  
  
  CONCLUSIONS
  The accuracy between FFR and MPS SPECT was moderate.
authors.affiliation: Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhou
authors.affiliation: Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031.
authors.forename: Lin-Feng
authors.initials: LF
authors.lastname: Yang
authors.affiliation: Department of Medical Imaging, The Branch of TaiAn Central Hospital, Middle of Changcheng Road, Shandong Province, China. 271000.
authors.forename: Ji-Liang
authors.initials: JL
authors.lastname: Zhai
authors.affiliation: Department of Medical Imaging, Affiliated Hospital of Taishan Medical University, No, 706, Taishan Road, Shandong Province, China. 271000.
authors.forename: Jiang
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Medical Imaging, Taishan Hospital of Traditional Chinese Medicine, No, 216, Yingxuan Street, Shandong Province, China. 271000.
authors.forename: Qi-Meng
authors.initials: QM
authors.lastname: Wang
authors.affiliation: Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031.
authors.forename: Rui-Jie
authors.initials: RJ
authors.lastname: Zhang
authors.affiliation: Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031.
authors.forename: Sen
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031.
authors.forename: Zhao-Hui
authors.initials: ZH
authors.lastname: Peng
authors.affiliation: Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031. Electronic address: liminyingxiang@163.com.
authors.forename: Min
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Medical Imaging, Jinan Military General Hospital, No, 25, Shifan Road, Jinan, Shandong Province, China. 250031. Electronic address: cjr.sungang@vip.163.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Sun
mesh_terms: D000368:Aged; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000706:statistics & numerical data*; D015984:Causality; D015897:Comorbidity; D017023:Coronary Angiography / Q000706:statistics & numerical data; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000453:epidemiology*; D055414:Myocardial Perfusion Imaging / Q000706:statistics & numerical data*; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity
keywords: Coronary artery disease; Fractional flow reserve; Myocardial perfusion SPECT; Quantitative coronary angiography