A meta-analysis comparing SPECT with PET for the assessment of myocardial viability in patients with coronary artery disease

Nucl Med Commun. 2014 Sep;35(9):947-54. doi: 10.1097/MNM.0000000000000140.

Abstract

Objective: The aim of this meta-analysis was to examine the diagnostic accuracy of single-photon emission computed tomography (SPECT) for the assessment of myocardial viability in patients with coronary artery disease as compared with PET.

Materials and methods: The literature was searched using the following keywords: single-photon emission computed tomography, positron emission tomography, perfusion, viability, myocardial infarction. Studies involving patients with coronary artery disease, left ventricular dysfunction, or a history of myocardial infarction and that compared SPECT and PET for the assessment of myocardial viability were included in the analysis.

Results: Eight studies including 310 patients were included in the meta-analysis. The total number of myocardial segments analyzed was 3580. The sensitivity and specificity of SPECT for the eight studies ranged from 59 to 95% and from 79 to 100%, respectively. The pooled sensitivity of SPECT was 82% [95% confidence interval (CI): 81-84%]. The pooled specificity of SPECT was 88% (95% CI: 86-90%). For all studies, the pooled diagnostic odds ratio was 62.60 (95% CI: 19.29-203.15) and the area under the receiver-operating characteristic curve was 0.945, indicating that SPECT could accurately assess myocardial viability.

Conclusion: The meta-analysis indicated that SPECT can accurately assess myocardial viability, as compared with PET, and supports the use of SPECT for the assessment of myocardial viability in patients with coronary artery disease.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review

MeSH terms

  • Aged
  • Comorbidity
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / epidemiology*
  • Female
  • Humans
  • Male
  • Myocardial Stunning / diagnostic imaging*
  • Myocardial Stunning / epidemiology*
  • Positron-Emission Tomography / statistics & numerical data*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon / statistics & numerical data*