A meta-analysis comparing SPECT with PET for the assessment of myocardial viability in patients with coronary artery disease.
OBJECTIVE
The aim of this meta-analysis was to examine the diagnostic accuracy of single-photon emission computed tomography (SPECT) for the assessment of myocardial viability in patients with coronary artery disease as compared with PET.


METHODS
The literature was searched using the following keywords: single-photon emission computed tomography, positron emission tomography, perfusion, viability, myocardial infarction. Studies involving patients with coronary artery disease, left ventricular dysfunction, or a history of myocardial infarction and that compared SPECT and PET for the assessment of myocardial viability were included in the analysis.


RESULTS
Eight studies including 310 patients were included in the meta-analysis. The total number of myocardial segments analyzed was 3580. The sensitivity and specificity of SPECT for the eight studies ranged from 59 to 95% and from 79 to 100%, respectively. The pooled sensitivity of SPECT was 82% [95% confidence interval (CI): 81-84%]. The pooled specificity of SPECT was 88% (95% CI: 86-90%). For all studies, the pooled diagnostic odds ratio was 62.60 (95% CI: 19.29-203.15) and the area under the receiver-operating characteristic curve was 0.945, indicating that SPECT could accurately assess myocardial viability.


CONCLUSIONS
The meta-analysis indicated that SPECT can accurately assess myocardial viability, as compared with PET, and supports the use of SPECT for the assessment of myocardial viability in patients with coronary artery disease.
aDepartment of Biomedical Imaging and Radiological Sciences, National Yang Ming University bDepartment of Internal Medicine, Division of Cardiology cDepartment of Radiology, Mackay Memorial Hospital dMackay Medicine, Nursing and Management College, Taipei, Taiwan.
Jui-Peng
JP
Tsai
Chun-Ho
CH
Yun
Tung-Hsin
TH
Wu
Chih-Hsuan
CH
Yen
Charles Jia-Yin
CJ
Hou
Jen-Yuan
JY
Kuo
Chung-Lieh
CL
Hung
D000368:Aged; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D017682:Myocardial Stunning / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000706:statistics & numerical data*