Direct Comparison of Cardiac Magnetic Resonance and Multidetector Computed Tomography Stress-Rest Perfusion Imaging for Detection of Coronary Artery Disease

• Type: Article in International Scientific Journal
• Date: 2013

Authors

Bettencourt, N (Author) Other; Chiribiri, A (Author) Other; Schuster, A (Author) Other; Ferreira, N (Author) Other; Sampaio, F (Author) Other; Pires Morais, G (Author) Other; Santos, L (Author) Other; Melica, B (Author) Other; Rodrigues, A (Author) Other; Braga, P (Author) Other; Azevedo L (Author) FMUP; Teixeira, M (Author) Other; Leite-Moreira AF (Author) FMUP; Silva Cardoso, J (Author) FMUP; Nagel, E (Author) Other; Gama, V (Author) Other

Journal

Title: Journal of the American College of Cardiology

Vol. 61

Pages: 1099-1107

ISSN: 0735-1097

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 124 Citations

Scopus - 126 Citations

Other information

Authenticus ID: P-002-013

DOI: 10.1016/j.jacc.2012.12.020

Abstract (EN): Objectives This study sought to compare the diagnostic performance of a multidetector computed tomography (MDCT) integrated protocol (IP) including coronary angiography (CTA) and stress-rest perfusion (CTP) with cardiac magnetic resonance myocardial perfusion imaging (CMR-Perf) for detection of functionally significant coronary artery disease (CAD). Background MDCT stress-rest perfusion methods were recently described as adjunctive tools to improve CTA accuracy for detection of functionally significant CAD. However, only a few studies compared these MDCT-IP with other clinically validated perfusion techniques like CMR-Perf. Furthermore, CTP has never been validated against the invasive reference standard, fractional flow reserve (FFR), in patients with suspected CAD. Methods 101 symptomatic patients with suspected CAD (62 +/- 8.0 years, 67% males) and intermediate/high pre-test probability underwent MDCT, CMR and invasive coronary angiography. Functionally significant CAD was defined by the presence of occlusive/subocclusive stenoses or FFR measurements <= 0.80 in vessels >2mm. Results On a patient-based model, the MDCT-IP had a sensitivity, specificity, positive and negative predictive values of 89%, 83%, 80% and 90%, respectively (global accuracy 85%). These results were closely related with those achieved by CMR-Perf: 89%, 88%, 85% and 91%, respectively (global accuracy 88%). When comparing test accuracies using non-inferiority analysis, differences greater than 11% in favour of CMR-Perf can be confidently excluded. Conclusions MDCT protocols integrating CTA and stress-rest perfusion detect functionally significant CAD with similar accuracy as CMR-Perf. Both approaches yield a very good accuracy. Integration of CTP and CTA improves MDCT performance for the detection of relevant CAD in intermediate to high pre-test probability populations. (J Am Coll Cardiol 2013;61:1099-107) (C) 2013 by the American College of Cardiology Foundation

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9