https://scholars.lib.ntu.edu.tw/handle/123456789/624398
標題: | Diagnostic Effect of Attenuation Correction in Myocardial Perfusion Imaging in Different Coronary Arteries: A Systematic Review and Meta-Analysis | 作者: | JEI-YIE HUANG CHUN-KAI HUANG RUOH-FANG YEN KUO-LIONG CHIEN YEN-WEN WU |
關鍵字: | attenuation correction; myocardial perfusion imaging; single photon emission computed tomography; coronary artery; meta-analysis; MULTICENTER CLINICAL-TRIAL; FRACTIONAL FLOW RESERVE; CT ATTENUATION; COMPUTED-TOMOGRAPHY; SPECT; ACCURACY; PERFORMANCE; DISEASE; SCATTER; ANGIOGRAPHY | 公開日期: | 2021 | 出版社: | FRONTIERS MEDIA SA | 卷: | 8 | 來源出版物: | FRONTIERS IN CARDIOVASCULAR MEDICINE | 摘要: | Background: The aim of this study was to determine whether, and if so how, attenuation correction (AC) improves the diagnostic performance of myocardial perfusion imaging (MPI) in different coronary artery-supplied territories, using coronary angiography as the reference standard. Methods: PubMed and EMBASE were searched until December 2020 for studies evaluating AC MPI for the diagnosis of coronary artery disease (CAD) with vessel-based data. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. For each study, the sensitivity, specificity, diagnostic odds ratios and areas under summary receiver operating characteristic curves (AUC) with 95% confidence intervals were calculated to determine the diagnostic accuracy of AC compared to non-AC MPI. A bivariate mixed-effects model was used to pool the data. Subgroup analyses considering the type of radiotracer and type of AC were performed. Results: A total of 264 articles were screened, of which 22 studies (2,608 patients) were enrolled. Significant improvements in specificity [0.78 vs. 0.58 in overall CAD, 0.87 vs. 0.61 in right coronary artery (RCA)] and diagnostic odds ratios (16 vs. 8 in overall CAD, 18 vs. 7 in RCA) after AC were shown in overall CAD at a patient level and RCA stenosis. Improvements in AUC were also noted. MPI had a similar diagnostic performance for detecting left anterior descending and left circumflex coronary artery stenosis with or without AC. There were trends of decreased sensitivity after AC, but none were significant. Diagnostic odds ratio showed significant improvement after AC only in the technetium-99m subgroup. Conclusion: The results of this study suggest that AC should be applied to MPI to improve the diagnosis of CAD regardless of which type of radiotracer, and that AC MPI can improve the specificity of detecting RCA stenosis. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/624398 | ISSN: | 2297-055X | DOI: | 10.3389/fcvm.2021.756060 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。