Background
Methods
Protocol and registration
Eligibility criteria
Search strategy
Study selection
Data collection process
Data items
Quality assessment
Statistical analysis
Results
Study | No. Patients | Male | Agea
| HT (%) | DM (%) | smoking | Hypercholesterolemia (%) | History of PCI/CABG (5) | prevalence of CAD % | Previous MI (%) |
---|---|---|---|---|---|---|---|---|---|---|
Al-Saadi 2000 [27] | 34 | 32 | 59+/−11 | NS | NS | NS | NS | NS | 100 | NS |
Bertschinger 2001 [28] | 14 | NS | NS | NS | NS | NS | NS | NS | 93 | NS |
Ibrahim 2002 [29] | 25 | 19 | 63+/−13 | NS | 28 | NS | 68 | 56 | 100 | 12 |
Nagel 2003 [30] | 84 | 73 | 63+/−8 | 0 | 0 | 21 | NS | NS | 51 | 0 |
Giang 2004 [31] | 29 | 25 | 58+/−8 | 45 | 14 | 34 | 59 | 52 | 66 | 38 |
Plein 2005 [32] | 92 | 68 | 58+/−11 | 30 | 8 | 35 | 54 | NS | 64 | 19 |
Rieber 2006 [33] | 43 | 38 | 66+/−8 | 86 | 23 | 35 | NS | 28 | 67 | 19 |
Positano 2006 [34] | 32 | 20 | 65+/−10 | NS | NS | NS | NS | NS | 50 | NS |
Costa 2007 [35] | 37 | 16 | 65+/−11 | 80 | 23 | 20 | 57 | NS | 97 | NS |
Pignitore 2008 [36] | 125 | 51 14 | 62+/−7 60+/−5 | 73 78 | 27 26 | 51 59 | 70 66 | NS | 71 | NS |
KrittayaPhong 2009 [37] | 66 | 38 | 61+/−12 | 62 | 27 | 8 | 62 | Exclusion criterium | 58 | Exclusion criterium |
Kirschbaum 2011 [38] | 40 | 27 | 62+/−7 | 49 | 15 | 29 | 41 | NS | 34 | NS |
Lockie 2011 [39] | 42 | 33 | 57+/−10 | NS | 19 | 21 | Exclusion criterium | 19 | NS | Exclusion criterium |
Bernhardt 2012 [25] | 34 | 26 | 62+/−11 | 80 | 15 | 47 | 53 | NS | 62 | NS |
Huber 2012 [24] | 23 | 27 | 67+/−12 | 36 | 23 | 85 | 29 | NS | 55 | 19 |
Motwani 2012 [40] | 40 | 27 | 64+/−8 | NS | NS | NS | NS | NS | 53 | NS |
Chiribiri 2013 [41] | 30 | 22 | 59+/−11 | NS | 27 | 27 | NS | NS | 80 | NS |
Mordini 2014 [20] | 67 | 45 | 60+/−11 | 60 | 16 | 42 | 75 | 25 | 34 | 25 |
Motwani 2014 [42] | 35 | 26 | 62+/−8 | 51 | 17 | 40 | 54 | 9 | 57 | 9 |
Yun 2015 [43] | 58 | 17 | 60+/−11 | 59 | 26 | 28 | 48 | 10 | 31 | 16 |
Pan 2015 [44] | 71 | 57 | 60+/−6 | 8 | 31 | 61 | 62 | 9 | 55 | NS |
Papanastasiou 2016 [45] | 24 | 20 | 63 ± 7 | 13 | 3 | 6 | NS | 4 | 67 | 7 |
Study | Scanner | Protocol | Stressor agent | Contrast agent | Contrast dosage | Perfusion sequence |
---|---|---|---|---|---|---|
Al-Saadi 2000 [27] | 1.5 T, Philips | Rest/stress | Dipyridamole | Gadopentate (Magnevist) | 0.025 mmol/kg | T1-weighted inversion recovery single-shot turbo gradient echo |
Bertschinger 2001 [28] | 1.5 T, G.E. | Stress only | Dipyridamole | Gadodiamide (Omniscan) | NS | interleaved gradient-echo EPI |
Ibrahim 2002 [29] | 1.5 T, Phillips | Rest/stress | Adenosine | Gadopentate (Magnevist) | 0.05 mmol/l | A fast hybrid, gated-imaging sequence consisting of three short- axis slices was used |
Nagel 2003 [30] | 1.5 T, Philips | Rest/stress | Adenosine | Diethylenetriaminepentaacetic acid-gadolinium | 0.025 mmol/kg | single shot segmented k-space turbo-gradient-echo/echo-planar-imaging (EPI)-hybrid |
Giang 2004 [31] | 1.5 T, G.E. | Stress only | Adenosine | Gadopentate (Magnevist) | 0.05 mmol/kg | hybrid echo planar |
Plein 2005 [32] | 1.5 T, Philips | Rest/stress | Adenosine | Gadopentate (Magnevist) | 0.05 mmol/kg | dynamic segmented k-space gradient-echo combined with SENSE |
Rieber 2006 [33] | 1.5 T, Siemens | Stress/rest | Adenosine | Gadodiamide (Omniscan) | 0.05 mmol/kg | T1-weighted saturation recovery turbo flash |
Positano 2006 [34] | 1.5 G.E. | Rest/stress | Dipyridamole | Gadodiamide (Omniscan) | 0.1 mmol/kg | fast gradient-echo train |
Costa 2007 [35] | 1.5 Siemens | Stress/rest | Adenosine | Gadolinium (Magnevist) | 0.1 mmol/kg | single-shot gradient-echo |
Pignitore 2008 [36] | 1.5 G.E. | Rest/stress | Dipyridamole | Gadodiamide (Omniscan) | 0.1 mmol/kg | fast gradient-echo train |
KrittayaPhong 2009 [37] | 1.5 T, Phillips | Stress/rest | adenosine | Gadopentate (Magnevist) | 0.05 mmol/l | ECG-triggered, T1 weighted, inversion receovery single shot turbo gradient echo sequence |
Kirschbaum 2011 [38] | 1.5 T, GE Medical Systems | Rest/stress | adenosine | Gadopentate (Magnevist) | 0.05 mmol/kg | steady state free-precession technique |
Lockie 2011 [39] | 3.0 T, Philips | Stress/rest | Adenosine | Gadopentate (Magnevist) | 0.05 mmol/kg | saturation recovery gradient echo method |
Bernhardt 2012 [25] | 1.5 T/3.0 T, Philips | Stress/rest | Adenosine | Gadoterate meglumine (Dotarem) | 0.075 mmol/kg | steady state free-precession technique |
Huber 2012 [24] | 1.5 T, Siemens | NS | Adenosine | Gadopentate (Magnevist) | 0.05 mmol/kg | saturation turboFlash |
Motwani 2012 [40] | 3.0 Phillips | Stress/rest | Adenosine | Gadopentate (Magnevist) | 0.05 mmol/kg | Saturation-recovery gradient echo |
Chiribiri 2013 [41] | 3.0 T, Philips | Stress/rest | Adenosine | Gadopentate (Magnevist) | 0.05 mmol/kg | saturation-recovery gradient echo |
Mordini 2014 [20] | 1.5 T, Siemens | Stress/rest | Dipyridamole | Gadopentate (Magnevist) | 0.005 mmol/kg followed by 0.1 mmol/kg | saturation recovery hybrid echo-planar |
Motwani 2014 [42] | 3.0 T, Philips | Stress/rest | Adenosine | Gadobutrol (Gadovist) | 0.075 mmol/kg | 3D spoiled turbo gradient-echo |
Yun 2015 [43] | 3.0 T, Philips | Stress/rest | Dipyridamole | Gadobenate Dimeglumine (Multihance) | 0.05 mmol/kg | saturation recovery gradient-echo T1-weighted |
Pan 2015 [44] | 3.0 T, Siemens | Stress/rest | Adenosine | Gadobutrol (Gadovist) | 0.075 mmol/kg | T1-weighted saturation recovery turbo flash |
Papanastasiou 2016 [45] | 3.0 T, Siemens | Stress/rest | Adenosine | Gadobutrol (Gadovist) | 0.05 mmol/kg | Turbo-fast low saturation recovery single-shot gradient echo |
Study | Segmentation | Data interpretation | Reference standard | Cut-off values | Outcome variables |
---|---|---|---|---|---|
Al-Saadi 2000 [27] | 6 segments (mid ventricular) | Territory | QCA | ≥75% DS | Semi-quantitative |
Bertschinger 2001 [28] | 4 × 8 segments | Patient/Territory | QCA | ≥50% stenosis | Semi-quantitative |
Ibrahim 2002 [29] | 3 short axis slices 18 segments per slice/polar maps subdivided into 6 segments | Territory | QCA | >75% DS | Semi-quantitative |
Nagel 2003 [30] | 5 short axis slices 6 segments per slice | Patient | Visual ICA | ≥75% DS | Quantitative |
Giang 2004 [31] | 3 × 8 segments good quality score | Patient | QCA | ≥50% DS | Semi-quantitative |
Plein 2005 [32] | 16 segments (AHA) | Patient | Visual ICA | >70% DS | Quantitative |
Rieber 2006 [33] | 16 segments (AHA) | Territory | QCA + FFR | >50% DS on QCA and FFR ≤0.75 | Semi-quantitative |
Positano 2006 [34] | 3 short axis slices 16 segments | Segment | QCA | ≥75% DS | Semi-quantitative |
Costa 2007 [35] | 3 short axis 8 segments per slice | Segment | QCA | >70% DS | Quantitaive |
Pignitore 2008 [36] | 3 short axis slices 16 segments | Segment | QCA | ≥50% DS | Semi-quantitative |
KrittayaPhong 2009 [37] | 16 segments (AHA) | Patient | Visual ICA | ≥50% | Semi-quantitative |
Kirschbaum 2011 [38] | 16 segments (AHA) | Patient | ICA with CFR | CFR < 2.0 | Semi-quantitative |
Lockie 2011 [39] | 16 segments (AHA) | Territory | FFR | <0.75 | Quantitative |
Bernhardt 2012 [25] | 16 segments (AHA) | Patient | FFR | ≤0.80 | Semi-quantitative |
Huber 2012 [24] | 18 segments (6 per slice) | Territory | QCA + FFR | >75% DS on QCA or 51 - 75% DS on QCA + FFR <0.75 | Semi-quantitative/Quantitative |
Motwani 2012 [40] | 1 midventricular slice 6 segments | Segment | QCA | >70% DS | Quantitative |
Chiribiri 2013 [41] | 16 segments (AHA) | Territory | FFR | <0.80 | Quantitative |
Mordini 2014 [20] | 3 short axis slices 12 segments per slice | Patient | QCA | >70% DS | Semi-quantitative/Quantitative |
Motwani 2014 [42] | Whole heart | Territory | QCA | ≥75% DS | Quantitative |
Yun 2015 [43] | 16 segments (AHA) | Territory | QCA | >70% DS | Semi-quantitative |
Pan 2015 [44] | 16 segments (AHA) (mean of 2 lowest value assigned to coronary territories) | Territory | FFR | ≤0.75 | Quantitative |
Papanastasiou 2016 [45] | 16 segments (AHA) | Patient/Territory | ICA + FFR | ≥70% DS on ICA or FFR <0.80 and luminal stenosis ≥50% | Quantitative |
Diagnostic performance
No. Studies | No. S/T/P | Sensitivity | Q-statistics p-valuea
| I2b
| Specificity | Q-statistics p-valuea
| I2b
| PLR | NLR | DOR | AUC | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Per Segment
|
4
|
3838
|
0.88 (0.82–0.93)
|
0.00
|
82.04
|
0.72 (0.56–0.84)
|
0.00
|
96.23
|
3.1 (1.0–5.10)
|
0.16 (0.10–0.26)
|
19 (9–40)
|
0.90 (0.870.92)
|
Per territory
|
12
|
1058
|
0.82 (0.77–0.86)
|
0.49
|
0.00
|
0.83 (0.74–0.90)
|
0.00
|
90.68
|
5.0 (3.1–7.9)
|
0.22 (0.17–0.29)
|
23 (12–44)
|
0.84 (0.81–0.87)
|
Anatomical reference | 5 | 370 | 0.85 (0.78–0.90) | 0.49 | 0.00 | 0.83 (0.72–0.91) | 0.00 | 78.11 | 5.1 (2.9–9.2) | 0.18 (0.12–0.27) | 28 (13–63) | 0.86 (0.83–0.89) |
Functional reference | 7 | 688 | 0.77 (0.63–0.86) | 0.00 | 86.70 | 0.85 (0.73–0.92) | 0.00 | 93.19 | 5.1 (2.5–10.3) | 0.28 (0.16–0.48) | 18 (6–59) | 0.88 (0.84–0.90) |
Semi-quantitative | 6 | 343 | 0.77 (0.60–0.88) | 0.00 | 86.96 | 0.84 (0.76–0.89) | 0.30 | 17.10 | 4.7 (2.9–7.8) | 0.28 (0.15–0.53) | 17 (6–50) | 0.87 (0.84–0.90) |
Quantitative | 6 | 729 | 0.77 (0.62–0.87) | 0.00 | 89.39 | 0.86(0.72–0.94) | 0.00 | 94.92 | 5.5 (2.4–12.6) | 0.27 (0.14–0.49) | 21 (6–8) | 0.88(0.85–0.91) |
Per patient
|
10
|
566
|
0.83 (0.75–0.88)
|
0.01
|
60.71
|
0.76 (0.65–0.85)
|
0.00
|
66.27
|
3.5 (2.2–5.5)
|
0.23 (0.14–0.36)
|
15 (6–36)
|
0.87 (0.84–0.90)
|