j.jcct.2011.10.018
Ali Salavati, MD, MPH, Farid Radmanesh, MD, MPH, Kazem Heidari, MD, PhD, Ben A. Dwamena, MD, Aine M. Kelly, MD, MS, Paul Cronin, MD, MS
BACKGROUND: Development of an accurate test for noninvasive assessment of coronary arteries has been highly desirable.
OBJECTIVES: We performed a systematic review of diagnostic accuracy of the dual-source computed tomography (DSCT) in the diagnosis of coronary artery disease (CAD).
METHODS: Eight medical databases were searched for articles published from January 2005 through March 2011. Studies compared DSCT coronary angiography (DSCT-CA) and invasive coronary angiography, as the reference standard, in consecutive patients with suspected or known CAD, and relevant data were extracted by 2 independent reviewers. Summary diagnostic accuracies were calculated, and the effect of covariates on the diagnostic performance was evaluated by meta-regression.
RESULTS: Twenty-five studies were included. In per-patient analysis (n = 2303), pooled sensitivity was 99% [95% confidence interval (CI), 97%-99%] with specificity of 89% (95% CI, 84%-92%). The summary positive (+LR) and negative (—LR) likelihood ratios were 8.6 (95% CI, 6.4-11.6) and 0.02 (95% CI, 0.01-0.03), respectively. In per-segment analysis (n = 32,615), pooled sensitivity was 94% (95% CI, 92%-96%) with specificity of 97% (95% CI, 96%-98%). Summary +LR and -LR were 30.2 (95% CI, 22.1-43.5) and 0.06 (95% CI, 0.04-0.08), respectively.
CONCLUSIONS: DSCT-CA seems to be robust to elevate heart rates while maintaining a high level of diagnostic performance. © 2012 Society of Cardiovascular Computed Tomography. All rights reserved.