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MR-IMPACT: comparison of perfusion-cardiac magnetic resonance with single-photon emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trial

Schwitter, Juerg ; Wacker, Christian M. ; van Rossum, Albert C. ; Lombardi, Massimo ; Al-Saadi, Nidal ; Ahlstrom, Hakan ; Dill, Thorsten ; Larsson, Henrik B.W. ; Flamm, Scott D. ; Marquardt, Moritz ; Johansson, Lars

In: European Heart Journal, 2008, vol. 29, no. 4, p. 480-489

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    Titel
    • MR-IMPACT: comparison of perfusion-cardiac magnetic resonance with single-photon emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trial
    Autor
    • Schwitter, Juerg. Division of Cardiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
    • Wacker, Christian M.. University Hospital Wuerzburg, Wuerzburg, Germany
    • van Rossum, Albert C.. VU University Medical Center, Amsterdam, The Netherlands
    • Lombardi, Massimo. Clinical Physiology Institute, Pisa, Italy
    • Al-Saadi, Nidal. Charité, Berlin, Germany
    • Ahlstrom, Hakan. University Hospital Uppsala, Uppsala, Sweden
    • Dill, Thorsten. Kerckhoff Clinics, Bad Nauheim, Germany
    • Larsson, Henrik B.W.. St Olaf University Hospital, Trondheim, Norway
    • Flamm, Scott D.. St Luke's Episcopal Hospital, Texas Heart Institute, Houston, TX, USA
    • Marquardt, Moritz. GE Healthcare Buchler GmbH & Co. KG, Munich, Germany
    • Johansson, Lars. University Hospital Uppsala, Uppsala, Sweden
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • European Heart Journal, 2008, vol. 29, no. 4, p. 480-489. Oxford University Press
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:296072
    Summary
    Aims To determine in a multicentre, multivendor trial the diagnostic performance for perfusion-cardiac magnetic resonance (perfusion-CMR) in comparison with coronary X-ray angiography (CXA) and single-photon emission computed tomography (SPECT). Methods and results Of 241 eligible patients from 18 centres, 234 were randomly dosed with 0.01, 0.025, 0.05, 0.075, or 0.1 mmol/kg Gd-DTPA-BMA (Omniscan™, GE-Healthcare) per stress (0.42 mg/kg adenosine) and rest perfusion study. Coronary artery disease (CAD) was defined as diameter stenosis ≥50% on quantitative CXA. Five CMR and eight SPECT studies (of 225 complete studies) were excluded from analyses due to inadequate quality (three blinded readers scored per modality). The comparison of CMR vs. SPECT was based on receiver operating characteristic (ROC) analysis. Perfusion-CMR at the optimal CM dose (0.1 mmol/kg) had similar performance as SPECT, if only the SPECT studies of the 42 patients with this dose were considered [area under ROC curve (AUC): 0.86 ± 0.06 vs. 0.75 ± 0.09 for SPECT, P = 0.12]; however, diagnostic performance of perfusion-CMR was better vs. the entire SPECT population (AUC: 0.67 ± 0.05, n = 212, P = 0.013). Conclusions In this multicentre, multivendor trial, ROC analyses suggest perfusion-CMR as a valuable alternative to SPECT for CAD detection showing equal performance in the head-to-head comparison. Comparing perfusion-CMR with the entire SPECT population suggests CMR superiority over SPECT, which warrants further evaluation in larger trials