Introduction
Materials and methods
Protocol and registration
Eligibility criteria
Study endpoints
Search strategy
Data collection, data extraction, and risk of bias and applicability
Statistical analysis
Results
Literature search and study characteristics
Author | Publication date | N | Age | Men | BMI | DM | HC | Smoke | AF | Sinus rhythm | HT | CAD | PCI | CABG |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Year | No. | Years | % | % | % | % | % | % | % | % | % | % | % | |
Pontone et al [26] | 2011 | 60 | 80 | 36.6 | 25 | 13 | 40 | 25 | 0 | 100 | 67 | 37 | 24 | 16 |
Andreini [30] | 2014 | 325 | 81.1 | 40.6 | 25.6 | 30 | 53 | 20 | 0 | 100 | 74 | 28 | 15 | 13 |
Hamdan et al [28] | 2015 | 115 | 81.4 | 43.5 | NR | 30 | 70 | 36.5 | 7.8 | 92.2 | 85 | 52.2 | 29 | 20 |
Harris et al [12] | 2015 | 100 | 79.6 | 61 | NR | 24 | 72 | 59 | 36 | 74 | 92 | 57 | 16 | 41 |
Opolsky et al [27] | 2015 | 475 | 82 | 41 | 27.5 | 32 | 48 | NR | 19 | 75 | 95 | 67 | 48 | 19 |
Matsumoto et al [25] | 2016 | 60 | 84.4 | 28.3 | 22.2 | NR | NR | NR | NR | NR | NR | 13 | 10 | 3.3 |
Rossi et al [19] | 2017 | 140 | 82.3 | 48.6 | 27.1 | 21 | 59 | 19 | 0 | 100 | 75 | 0 | 0 | 0 |
Annoni et al [22] | 2018 | 115 | 82.3 | 55.7 | 26.7 | 18 | 69 | 7 | 13 | 87 | 71 | 20.8 | 15 | 6.1 |
Hachulla [24] | 2019 | 84 | 84.65 | 48.1 | 26.9 | NR | NR | NR | NR | NR | NR | NR | NR | NR |
Strong et al [20] | 2019 | 200 | 83.4 | 40 | 26.6 | 28 | 74 | 21.5 | 34 | 76.5 | 93 | 0 | 0 | 0 |
Schicchi et al [29] | 2020 | 223 | 79.2 | NR | NR | NR | NR | NR | NR | NR | NR | 51.6 | 35 | 16.6 |
Gohmann et al [21] | 2020 | 388 | 79.6 | 50.8 | 29.2 | 13 | 59 | 8 | NR | 64.7 | 89 | 41.4 | 29 | 0 |
Shuai et al [23] | 2020 | 121 | 73.3 | 47.1 | 22.6 | 26 | 12 | 25 | 27 | 73.8 | 37 | NR | 0 | 0 |
Meier et al [18] | 2021 | 127 | 82.3 | 38.6 | 26.5 | 28 | 54 | NR | NR | NR | 77 | 38.6 | 17 | 0 |
Author | Publication date | CT scanner | X-ray source | Detector rows | Detector element z-dimension | Total detector z-axis coverage | Dual energy | rotation time | Intrinsic temporal resolution | Single-heart beat CT scanner | Tube voltage | Tube current |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Year | Detector design | Slices | mm | mm | In the present study | ms/rot | ms | Yes/no | Mean kVp | Mean mA | ||
Pontone et al [26] | 2011 | LightSpeed VCT XT Scanner (GE Healthcare) | Single | 64 | 0.625 | 40 | No | 350 | 175 | No | 120 | 650 |
Andreini [30] | 2014 | LightSpeed VCT XT Scanner (GE Healthcare) | Single | 64 | 0.625 | 40 | No | 350 | 175 | No | 105 | 575 |
Hamdan et al [28] | 2015 | Brilliance iCT Elite (Philips Healthcare) | Single | 128 | 0.625 | 80 | No | 270 | 135 | No | 100 | 485 |
Harris et al [12] | 2015 | Somatom Definition Flash Stellar (Siemens Healthcare) | Dual | 64 | 0.6 | 38.4 | No | 285 | 75 | No | NR | NR |
Opolsky et al [27] | 2015 | Somatom Definition (Siemens Healthcare) | Dual | 64 | 0.6 | 38.4 | No | 330 | 83 | No | 120 | 360 |
Matsumoto et al [25] | 2016 | Aquilion ONE Vision (Toshiba Medical Systems) | Single | 320 | 0.5 | 160 | No | 275 | 137 | Yes | 100 | 382.5 |
Rossi et al [19] | 2017 | Somatom Definition Flash Stellar (Siemens Healthcare) | Dual | 64 | 0.6 | 38.4 | No | 280 | 75 | No | 100 | 363.3 |
Annoni et al [22] | 2018 | Revolution CT (GE Healthcare) | Single | 256 | 0.625 | 160 | No | 280 | 140 | Yes | 100 | 583.3 |
Hachulla [24] | 2019 | Somatom Definition Flash Stellar (Siemens Healthcare) | Dual | 64 | 0.6 | 38.4 | No | 280 | 75 | No | 120 | NR |
Strong et al [20] | 2019 | Somatom Definition Flash Stellar (Siemens Healthcare) | Dual | 64 | 0.6 | 38.4 | No | 280 | 75 | No | 110 | NR |
Schicchi et al [29] | 2020 | Somatom Force (Siemens Healthineers) | Dual | 96 | 0.6 | 57.6 | No | 250 | 66 | Yes | 120 | NR |
Gohmann et al [21] | 2020 | Somatom Definition Flash Stellar (Siemens Healthcare) | Dual | 64 | 0.6 | 38.4 | No | 280 | 75 | No | 86.7 | NR |
Shuai et al [23] | 2020 | Revolution CT (GE Healthcare) | Single | 256 | 0.625 | 160 | No | 280 | 140 | Yes | 100 | 400 |
Meier et al [18] | 2021 | LightSpeed VCT XT; Revolution CT (GE Healthcare) | Single; single | 64; 256 | 0.625 | 40; 160 | No; no | 350; 280 | 175; 140 | No; yes | 110 | 500 |
Assessment of study quality
Diagnostic accuracy: primary endpoint
Author | Publication date | N | TP | FN | FP | TN | Se | Sp |
---|---|---|---|---|---|---|---|---|
Year | No. | No. | No. | No. | No. | % (CI 95%) | % (CI 95%) | |
Pontone et al [26] | 2011 | 60 | 23 | 3 | 4 | 30 | 88.5 (69.9 – 97.6) | 88.2 (72.6 – 96.7) |
Hamdan et al [28] | 2015 | 115 | 47 | 2 | 18 | 48 | 95.9 (86.0 – 99.5) | 72.7 (60.4 – 83.0) |
Harris et al [12] | 2015 | 100 | 73 | 1 | 11 | 15 | 98.7 (92.7 – 99.9) | 57.7 (28.1 – 63.7) |
Opolsky et al [27] | 2015 | 475 | 265 | 5 | 129 | 76 | 98.2 (95.7 – 99.4) | 37.1 (30.5 – 44.1) |
Matsumoto et al [25] | 2016 | 66 | 22 | 2 | 21 | 21 | 91.7 (73.0 – 99.0) | 50.0 (34.2 – 65.8) |
Rossi et al [19] | 2017 | 145 | 58 | 5 | 37 | 45 | 92.1 (82.4 – 97.4) | 54.9 (43.5 – 65.9) |
Annoni et al [22] | 2018 | 115 | 22 | 1 | 12 | 80 | 95.7 (78.1 – 99.9) | 87.0 (78.3 – 93.1) |
Strong et al [20] | 2019 | 200 | 69 | 0 | 76 | 55 | 100.0 (94.8 – 100.0) | 42.0 (33.4 – 50.9) |
Schicchi et al [29] | 2020 | 223 | 44 | 1 | 20 | 158 | 97.8 (88.2 – 99.9) | 88.8 (61.9 – 82.9) |
Gohmann et al [21] | 2020 | 388 | 135 | 3 | 137 | 113 | 97.8 (93.8 – 99.6) | 45.2 (32.9 – 51.6) |
Shuai et al [23] | 2020 | 130 | 28 | 1 | 11 | 90 | 96.6 (82.2 – 99.9) | 89.1 (81.4 – 94.4) |
Meier et al [18] | 2021 | 127 | 43 | 6 | 33 | 45 | 87.8 (75.2 – 95.4) | 57.7 (46.0 – 68.8) |
Analysis | N | TP | FP | FN | TN | Se | Sp | + LR | − LR | DOR |
---|---|---|---|---|---|---|---|---|---|---|
No. | No. | No. | No. | No. | % (CI 95%) | % (CI 95%) | % (CI 95%) | % (CI 95%) | n (CI 95%) | |
Patient level 1a) | 2228 | 872 | 518 | 30 | 808 | 97 (94 – 98) | 68 (56 – 78) | 3.0 (2.1 – 4.3) | 0.05 (0.03 – 0.09) | 60 (30 – 121) |
Patient level 1b) | 794 | 252 | 123 | 16 | 403 | 94 (89 – 97) | 80 (64 – 90) | 4.6 (2.4 – 8.8) | 0.08 (0.04 – 0.14) | 59 (23 – 149) |
Vessel level | 6865 | 1307 | 1529 | 102 | 3927 | 92 (88 – 95) | 79 (70 – 86) | 4.4 (3.1 – 6.3) | 0.10 (0.07 – 0.15) | 42 (25 – 74) |
Segment level | 13525 | 1379 | 1408 | 81 | 10657 | 95 (89 – 98) | 91 (83 – 95) | 10.6 (5.6 – 20.4) | 0.06 (0.03 – 0.12) | 189 (61 – 583) |
Sub-analysis: sensitivity and subgroup analysis
CT scanner feature | Present | N | TP | FP | FN | TN | Se | Sp | + LR | − LR | DOR | HSROC |
---|---|---|---|---|---|---|---|---|---|---|---|---|
No. | No. | No. | No. | No. | % (CI 95%) | % (CI 95%) | % (CI 95%) | % (CI 95%) | n (CI 95%) | AUC | ||
Whole-heart coverage CT scanner | Yes | 311 | 72 | 44 | 4 | 191 | 95 (86 – 98) | 80 (57 – 92) | 4.6 (1.9 – 11.2) | 0.06 (0.02 – 0.20) | 73 (12 – 454) | 0.96 (0.94 – 0.97) |
No | 1790 | 757 | 441 | 20 | 572 | 97 (95 – 98) | 65 (50 – 77) | 2.8 (1.9 – 4.1) | 0.04 (0.02 – 0.08) | 64 (31 – 130) | 0.97 (0.95 – 0.98) | |
High temporal resolution CT scanners | Yes | 1615 | 687 | 419 | 15 | 494 | 98 (96 – 99) | 59 (43 – 74) | 2.4 (1.6 – 3.6) | 0.03 (0.01 – 0.08) | 73 (26 – 206) | 0.97 (0.95 – 0.98) |
No | 486 | 142 | 66 | 9 | 269 | 94 (89 – 97) | 80 (66 – 89) | 4.7 (2.6 – 8.5) | 0.07 (0.04 – 0.14) | 64 (23 – 179) | 0.95 (0.92 – 0.96) | |
Single-heartbeat CT scanner | Yes | 1567 | 713 | 421 | 19 | 414 | 96 (90 – 99) | 82 (66 – 92) | 5.4 (2.6 – 11.3) | 0.05 (0.02 – 0.14) | 112 (23 – 548) | 0.97 (0.95 – 0.98) |
No | 534 | 116 | 64 | 5 | 349 | 97 (94 – 98) | 60 (46 – 72) | 2.4 (1.7 – 3.3) | 0.05 (0.03 – 0.09) | 47 (25 – 91) | 0.95 (0.93 – 0.97) |