Arham Muhammad, Dad Allah, Bin Abdul Malik Mohammad Hamza, Sajjad Talha, Bin Muhammad Awais, Haider Faseeh, Khan Mishal, Hamza Anfal, Arif Muhammad Hammad, Qureshi Muhammad Ahmad, Abdul Jabbar Ali Bin, Javed Muhammad Abdullah, Bakht Kinza
Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, Pakistan.
Nassau University Medical Center, New York, US.
Int J Cardiovasc Imaging. 2025 Aug 7. doi: 10.1007/s10554-025-03475-x.
Coronary artery disease (CAD) is the leading cause of cardiovascular mortality (CVD), accounting for 1 in 5 CVD-related deaths. The advent of non-invasive imaging modalities has driven the use of myocardial perfusion imaging (MPI) to enhance diagnostic accuracy and improve clinical outcomes in CAD. Building on the role of myocardial perfusion imaging (MPI), this meta-analysis assesses the diagnostic accuracy of the Discovery NM 530c CZT SPECT for CAD compared with invasive coronary angiography (ICA ± FFR) and noninvasive modalities, including PET, MRI, and coronary CT angiography. A systematic search of six databases was conducted to identify studies evaluating the diagnostic accuracy of the NM 530c CZT-SPECT for detecting CAD. Comparator modalities included ICA ± FFR, PET, MRI, or coronary CTA performed within 90 days. Diagnostic performance was assessed using pooled sensitivity, specificity, summary receiver operating characteristic (SROC) curves, and diagnostic odds ratio (DOR), using R (v2024.12.0 + 467) with the "meta" and "mada" packages. A bivariate meta-analysis of 11 studies showed a pooled sensitivity of 83.5% (95% CI: 77.3-88.3%) and specificity of 75.8% (95% CI: 67.8-82.3%), with an AUC of 0.858 and diagnostic odds ratio (DOR) of 15.9. Likelihood ratios were 3.45 (positive) and 0.22 (negative). The SSS ≥ 4 subgroup showed the highest sensitivity (0.881) and DOR (19.21). The univariate random-effects model yielded a pooled sensitivity of 83% and specificity of 77%. Heterogeneity was moderate, and Deeks' test showed no publication bias (p = 0.83). This meta-analysis establishes the Discovery NM 530c CZT SPECT as a reliable and clinically effective non-invasive modality for detecting coronary artery disease (CAD), with a pooled sensitivity of 0.835, specificity of 0.758, and AUC of 0.858, supporting its diagnostic utility across diverse clinical settings.
冠状动脉疾病（CAD）是心血管疾病死亡（CVD）的主要原因，占与CVD相关死亡人数的五分之一。非侵入性成像技术的出现推动了心肌灌注成像（MPI）的应用，以提高CAD的诊断准确性并改善临床结局。基于心肌灌注成像（MPI）的作用，本荟萃分析评估了Discovery NM 530c CZT SPECT与侵入性冠状动脉造影（ICA±FFR）以及包括PET、MRI和冠状动脉CT血管造影在内的非侵入性检查方法相比，对CAD的诊断准确性。对六个数据库进行了系统检索，以确定评估NM 530c CZT-SPECT检测CAD诊断准确性的研究。对照检查方法包括在90天内进行的ICA±FFR、PET、MRI或冠状动脉CTA。使用合并敏感性、特异性、汇总接收器操作特征（SROC）曲线和诊断比值比（DOR）评估诊断性能，使用R（v2024.12.0 + 467）以及“meta”和“mada”软件包。对11项研究的双变量荟萃分析显示，合并敏感性为83.5%（95%CI：77.3 - 88.3%），特异性为75.8%（95%CI：67.8 - 82.3%），AUC为0.858，诊断比值比（DOR）为15.9。似然比为3.45（阳性）和0.22（阴性）。SSS≥4亚组显示出最高的敏感性（0.881）和DOR（19.21）。单变量随机效应模型得出的合并敏感性为83%，特异性为77%。异质性为中度，Deeks检验显示无发表偏倚（p = 0.83）。本荟萃分析确定Discovery NM 530c CZT SPECT是一种可靠且临床有效的检测冠状动脉疾病（CAD）的非侵入性检查方法，合并敏感性为0.835，特异性为0.758，AUC为0.858，支持其在各种临床环境中的诊断效用。
