Diagnostic accuracy of magnetic resonance angiography for detection of coronary artery disease: a systematic review and meta-analysis

Giovanni Di Leo; Erica Fisci; Francesco Secchi; Marco Alì; Federico Ambrogi; Luca Maria Sconfienza; Francesco Sardanelli

doi:10.1007/s00330-015-4134-0

Diagnostic accuracy of magnetic resonance angiography for detection of coronary artery disease: a systematic review and meta-analysis

Giovanni Di Leo, Erica Fisci, Francesco Secchi, Marco Alì, Federico Ambrogi, Luca Maria Sconfienza, Francesco Sardanelli

Research output: Contribution to journal › Article

Abstract

OBJECTIVES: To review the diagnostic performance of MR coronary angiography (MRCA) for coronary artery disease (CAD).

METHODS: Two independent reviewers searched on MEDLINE/EMBASE with the following inclusion criteria: 01/01/2000-03/23/2015 publication date; per-patient sensitivity/specificity for >50 % stenosis confirmed by conventional coronary angiography with raw data provided or retrievable; sample size >10. Quality was appraised using QUADAS2.

RESULTS: Nine hundred eighteen studies were retrieved, 24 of them, including 1,638 patients, were selected. Using a bivariate model, the pooled sensitivity was 89 % (95 % confidence interval 86-92 %), the pooled specificity 72 % (63-79 %). Meta-regression did not show a significant impact on sensitivity/specificity for both year of publication and disease prevalence (p ≥ 0.114). Sensitivity of contrast-enhanced examinations (95 %, 90-97 %) was higher (p = 0.005) than that of unenhanced examinations (87 %, 83-90 %). Specificity of whole-heart acquisition mode (78 %, 72-84 %) was higher (p = 0.006) than that of targeted mode (57 %, 45-69 %). Specificity at 3 T (83 %, 69-92 %) was higher (p = 0.067) than that at 1.5 T (68 %, 60-76 %). Risk of bias and concerns regarding applicability were low.

CONCLUSIONS: Sensitivity and specificity of MRCA for CAD were 89 % and 72 %, respectively. A specificity higher than 80 % may be obtained at 3 T. Whole-heart contrast-enhanced protocols should be preferred for a higher diagnostic performance.

KEY POINTS: • MRCA sensitivity and specificity for CAD are below those of CTA. • Contrast administration increased sensitivity to 95 % (90-97 %), comparable with that of CTA. • Whole-heart mode increased specificity to 78 % (72-84 %), comparable with that of CTA. • Specificity at 3 T was borderline-significantly higher (p = 0.067) than at 1.5 T. • Whole-heart contrast-enhanced protocols are the best approach for MRCA.

Original language	English
Pages (from-to)	3706-18
Number of pages	13
Journal	European Radiology
Volume	26
Issue number	10
DOIs	https://doi.org/10.1007/s00330-015-4134-0
Publication status	Published - Oct 2016

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Keywords

Contrast Media
Coronary Angiography
Coronary Artery Disease
Coronary Stenosis
Humans
Magnetic Resonance Angiography
Sensitivity and Specificity
Journal Article
Meta-Analysis
Review

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Di Leo, G., Fisci, E., Secchi, F., Alì, M., Ambrogi, F., Sconfienza, L. M., & Sardanelli, F. (2016). Diagnostic accuracy of magnetic resonance angiography for detection of coronary artery disease: a systematic review and meta-analysis. European Radiology, 26(10), 3706-18. https://doi.org/10.1007/s00330-015-4134-0

Diagnostic accuracy of magnetic resonance angiography for detection of coronary artery disease : a systematic review and meta-analysis. / Di Leo, Giovanni; Fisci, Erica; Secchi, Francesco; Alì, Marco; Ambrogi, Federico; Sconfienza, Luca Maria ; Sardanelli, Francesco.

In: European Radiology, Vol. 26, No. 10, 10.2016, p. 3706-18.

Research output: Contribution to journal › Article

@article{ccc6c8690d324f80b929079e4d132bd5,

title = "Diagnostic accuracy of magnetic resonance angiography for detection of coronary artery disease: a systematic review and meta-analysis",

abstract = "OBJECTIVES: To review the diagnostic performance of MR coronary angiography (MRCA) for coronary artery disease (CAD).METHODS: Two independent reviewers searched on MEDLINE/EMBASE with the following inclusion criteria: 01/01/2000-03/23/2015 publication date; per-patient sensitivity/specificity for >50 % stenosis confirmed by conventional coronary angiography with raw data provided or retrievable; sample size >10. Quality was appraised using QUADAS2.RESULTS: Nine hundred eighteen studies were retrieved, 24 of them, including 1,638 patients, were selected. Using a bivariate model, the pooled sensitivity was 89 % (95 % confidence interval 86-92 %), the pooled specificity 72 % (63-79 %). Meta-regression did not show a significant impact on sensitivity/specificity for both year of publication and disease prevalence (p ≥ 0.114). Sensitivity of contrast-enhanced examinations (95 %, 90-97 %) was higher (p = 0.005) than that of unenhanced examinations (87 %, 83-90 %). Specificity of whole-heart acquisition mode (78 %, 72-84 %) was higher (p = 0.006) than that of targeted mode (57 %, 45-69 %). Specificity at 3 T (83 %, 69-92 %) was higher (p = 0.067) than that at 1.5 T (68 %, 60-76 %). Risk of bias and concerns regarding applicability were low.CONCLUSIONS: Sensitivity and specificity of MRCA for CAD were 89 % and 72 %, respectively. A specificity higher than 80 % may be obtained at 3 T. Whole-heart contrast-enhanced protocols should be preferred for a higher diagnostic performance.KEY POINTS: • MRCA sensitivity and specificity for CAD are below those of CTA. • Contrast administration increased sensitivity to 95 % (90-97 %), comparable with that of CTA. • Whole-heart mode increased specificity to 78 % (72-84 %), comparable with that of CTA. • Specificity at 3 T was borderline-significantly higher (p = 0.067) than at 1.5 T. • Whole-heart contrast-enhanced protocols are the best approach for MRCA.",

keywords = "Contrast Media, Coronary Angiography, Coronary Artery Disease, Coronary Stenosis, Humans, Magnetic Resonance Angiography, Sensitivity and Specificity, Journal Article, Meta-Analysis, Review",

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doi = "10.1007/s00330-015-4134-0",

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T1 - Diagnostic accuracy of magnetic resonance angiography for detection of coronary artery disease

T2 - a systematic review and meta-analysis

AU - Di Leo, Giovanni

AU - Fisci, Erica

AU - Secchi, Francesco

AU - Alì, Marco

AU - Ambrogi, Federico

AU - Sconfienza, Luca Maria

AU - Sardanelli, Francesco

PY - 2016/10

Y1 - 2016/10

N2 - OBJECTIVES: To review the diagnostic performance of MR coronary angiography (MRCA) for coronary artery disease (CAD).METHODS: Two independent reviewers searched on MEDLINE/EMBASE with the following inclusion criteria: 01/01/2000-03/23/2015 publication date; per-patient sensitivity/specificity for >50 % stenosis confirmed by conventional coronary angiography with raw data provided or retrievable; sample size >10. Quality was appraised using QUADAS2.RESULTS: Nine hundred eighteen studies were retrieved, 24 of them, including 1,638 patients, were selected. Using a bivariate model, the pooled sensitivity was 89 % (95 % confidence interval 86-92 %), the pooled specificity 72 % (63-79 %). Meta-regression did not show a significant impact on sensitivity/specificity for both year of publication and disease prevalence (p ≥ 0.114). Sensitivity of contrast-enhanced examinations (95 %, 90-97 %) was higher (p = 0.005) than that of unenhanced examinations (87 %, 83-90 %). Specificity of whole-heart acquisition mode (78 %, 72-84 %) was higher (p = 0.006) than that of targeted mode (57 %, 45-69 %). Specificity at 3 T (83 %, 69-92 %) was higher (p = 0.067) than that at 1.5 T (68 %, 60-76 %). Risk of bias and concerns regarding applicability were low.CONCLUSIONS: Sensitivity and specificity of MRCA for CAD were 89 % and 72 %, respectively. A specificity higher than 80 % may be obtained at 3 T. Whole-heart contrast-enhanced protocols should be preferred for a higher diagnostic performance.KEY POINTS: • MRCA sensitivity and specificity for CAD are below those of CTA. • Contrast administration increased sensitivity to 95 % (90-97 %), comparable with that of CTA. • Whole-heart mode increased specificity to 78 % (72-84 %), comparable with that of CTA. • Specificity at 3 T was borderline-significantly higher (p = 0.067) than at 1.5 T. • Whole-heart contrast-enhanced protocols are the best approach for MRCA.

AB - OBJECTIVES: To review the diagnostic performance of MR coronary angiography (MRCA) for coronary artery disease (CAD).METHODS: Two independent reviewers searched on MEDLINE/EMBASE with the following inclusion criteria: 01/01/2000-03/23/2015 publication date; per-patient sensitivity/specificity for >50 % stenosis confirmed by conventional coronary angiography with raw data provided or retrievable; sample size >10. Quality was appraised using QUADAS2.RESULTS: Nine hundred eighteen studies were retrieved, 24 of them, including 1,638 patients, were selected. Using a bivariate model, the pooled sensitivity was 89 % (95 % confidence interval 86-92 %), the pooled specificity 72 % (63-79 %). Meta-regression did not show a significant impact on sensitivity/specificity for both year of publication and disease prevalence (p ≥ 0.114). Sensitivity of contrast-enhanced examinations (95 %, 90-97 %) was higher (p = 0.005) than that of unenhanced examinations (87 %, 83-90 %). Specificity of whole-heart acquisition mode (78 %, 72-84 %) was higher (p = 0.006) than that of targeted mode (57 %, 45-69 %). Specificity at 3 T (83 %, 69-92 %) was higher (p = 0.067) than that at 1.5 T (68 %, 60-76 %). Risk of bias and concerns regarding applicability were low.CONCLUSIONS: Sensitivity and specificity of MRCA for CAD were 89 % and 72 %, respectively. A specificity higher than 80 % may be obtained at 3 T. Whole-heart contrast-enhanced protocols should be preferred for a higher diagnostic performance.KEY POINTS: • MRCA sensitivity and specificity for CAD are below those of CTA. • Contrast administration increased sensitivity to 95 % (90-97 %), comparable with that of CTA. • Whole-heart mode increased specificity to 78 % (72-84 %), comparable with that of CTA. • Specificity at 3 T was borderline-significantly higher (p = 0.067) than at 1.5 T. • Whole-heart contrast-enhanced protocols are the best approach for MRCA.

KW - Contrast Media

KW - Coronary Angiography

KW - Coronary Artery Disease

KW - Coronary Stenosis

KW - Humans

KW - Magnetic Resonance Angiography

KW - Sensitivity and Specificity

KW - Journal Article

KW - Meta-Analysis

KW - Review

U2 - 10.1007/s00330-015-4134-0

DO - 10.1007/s00330-015-4134-0

M3 - Article

C2 - 26662033

VL - 26

SP - 3706

EP - 3718

JO - European Radiology

JF - European Radiology

SN - 0938-7994

IS - 10

ER -

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10.1007/s00330-015-4134-0