Dual-source CT versus single-source 64-section CT angiography for coronary artery disease: A meta-analysis.
OBJECTIVE
To perform a meta-analysis to compare the diagnostic performance of single-source 64-section computed tomography (CT) versus dual-source CT angiography for diagnosis of coronary artery disease (CAD).


METHODS
The Cochrane Library, MEDLINE, and EMBASE were searched for relevant original papers. Inclusion criteria were (1) significant CAD defined as ≥50% reduction in luminal diameter by invasive coronary angiography as reference standard; (2) single-source 64-section CT or dual-source CT was used; (3) results were reported in absolute numbers of true-positive, false-positive, true-negative, and false-negative results or sufficiently detailed data for deriving these numbers were presented. A random-effects model was used for the meta-analysis.


RESULTS
Fifty-one papers including 3966 patients who underwent single-source 64-section CT and 2047 patients who underwent dual-source CT at a per-patient level were pooled. The diagnostic values of single-source 64-section CT versus dual-source CT were 97% versus 97% for sensitivity (p = 0.386), 78% versus 86% for specificity (p < 0.001), 90% versus 85% for positive predictive value (PPV; p < 0.001), 93% versus 97% for negative predictive value (NPV; p = 0.001), 6.8 versus 6.5 for positive likelihood ratio (p = 0.018), 0.04 versus 0.04 for negative likelihood ratio (p = 0.625), and 191.59 versus 207.37 for diagnostic odds ratio (p = 0.043), respectively.


CONCLUSIONS
Dual-source CT and single-source 64-section CT have similar negative likelihood ratios and, therefore, there was no significant difference in their utility to rule out CAD in intermediate-risk patients. However, compared to single-source 64-section CT, dual-source CT has significantly higher specificity, so that CT-based decisions for subsequent coronary catheter angiography are more accurate.
Department of Radiology, BenQ Medical Center, Nanjing Medical University, 71 Hexi Street, Jianye District, Nanjing 210019, China.
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Jiang
Department of Radiology, BenQ Medical Center, Nanjing Medical University, 71 Hexi Street, Jianye District, Nanjing 210019, China. Electronic address: fskwjc@126.com.
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Wang
Department of Interventional Radiology, BenQ Medical Center, Nanjing Medical University, 71 Hexi Street, Jianye District, Nanjing 210019, China.
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Lv
Department of Cardiology, BenQ Medical Center, Nanjing Medical University, 71 Hexi Street, Jianye District, Nanjing 210019, China.
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Cai
D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*