Abstract
Background: Previous meta-analyses have confirmed the high diagnostic performance of Computed Tomography Perfusion (CTP) for detecting coronary artery disease, which, nevertheless, was compared with Quantitative Coronary Angiography (QCA).
Methods: We searched PubMed for all published literature for all published studies that evaluated the consistence between catheter Fractional Flow Reserve (FFR) and CTP. The studies were included if the coherence between FFR and CTP was investigated. The basic information and numbers of true-positive, true negative, false-positive, and false-negative values were extracted by two investigators independently.
Results: Five studies were finally identified. Among the included references, 4 studies included data with hybrid CTP and CT angiography (CTA). The publication biases were not significant for studies with CTP (P = 0.88) and hybrid CTP/CTA (P= 0.21). The pooled positive likelihoods were 5.39 (95%CI 2.65-10.99) and 13.97 (95%CI, 9.62-20.30) for CTP and CTP/CTA, respectively, and negative likelihoods were 0.30 (95%CI, 0.19-0.49) and 0.23 (95%CI, 0.15-0.34). With hybrid imaging, the overall accuracy increased (P<0.05, the area under the summary ROC curve was 0.88 for CTP and 0.95 for hybrid CTP/CTA, respectively). The sensitivity analysis indicated that no study influenced the pooled results significantly.
Conclusion: With FFR as standard reference, CTP cannot be applied as an effective tool for diagnosing suspected coronary ischemic disease alone. Rather, hybrid CTP/CTA is suggested to improve the overall accuracy.
Citation
Yang Z, Xin-bo L, Zhou T, Bei-cheng W, Li M and Sun G et al., Diagnostic Performance of Combination Cardiac Computed Tomography Angiography with Perfusion with Fractional Flow Reserve as Standard Reference: Systematic Review and Meta Analysis. SM J Radiol. 2015; 1(2): 1007.