Background: Coronary artery disease (CAD) is the leading cause of cardiovascular mortality (CVD), accounting for 1 in 5 CVD-related deaths. The advent of noninvasive imaging modalities has driven the use of myocardial perfusion imaging (MPI) to improve diagnostic accuracy and clinical outcomes. Objectives: 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. Methodology: We systematically searched six databases, identifying 1,587 studies, with 9 meeting inclusion criteria (510 patients, ≥18 years, known/suspected CAD). NM 530c CZT-SPECT was compared with coronary angiography (±FFR), PET, MRI, or coronary CTA within 90 days. Diagnostic test accuracy was assessed using sensitivity, specificity, predictive values, AUC, and DOR, analyzed in R (Version 2024.12.0+467) using "mada" and related packages. Results: In bivariate analysis, NM 530c CZT-SPECT showed pooled sensitivity of 0.804 (95% CI: 0.751–0.848) and specificity of 0.793 (95% CI: 0.722–0.850) with low heterogeneity (29.8% and 26.2%, respectively). The diagnostic odds ratio (DOR) was 14.19 (95% CI: 8.47–23.77), confirming high diagnostic accuracy. On subgroup analysis, the comparator group had no significant impact on DOR (QM (df = 1) = 0.100, p = 0.752). Against ICA, sensitivity was 0.814 (95% CI: 0.726–0.878) and specificity 0.731 (95% CI: 0.638–0.807) with minimal heterogeneity (2.4%). AUC of 0.84 underscores its clinical reliability. Conclusion: NM 530c CZT-SPECT exhibits high diagnostic accuracy, with consistent sensitivity and modestly lower specificity than other invasive and noninvasive modalities. Its high AUC underscores its reliability for CAD assessment in clinical practice.
Arham et al. (Fri,) studied this question.