Heart failure & cardiomyopathies
Cardiac CT and Positron Emission Tomography (PET) for Surveillance of Heart Transplant Recipients: Systematic Review and Bayesian Meta-Analysis
Authors' conclusion
Both coronary CTA and PET can rule out significant CAV; however, at higher pretest probabilities, coronary CTA may be preferrable. Multiple PET-derived parameters may have prognostic value, whereas there is insufficient evidence for the long-term prognostic value of CT.
Study context
- Population
- Heart transplant recipients (surveillance for cardiac allograft vasculopathy)44 studies (32 CT, 12 PET)
- Participants
- 3,049 recipients
- Comparison
- Coronary computed tomography angiography (CTA) vs PET for cardiac allograft vasculopathy (CAV) surveillance
- Outcome
- Diagnostic accuracy for angiographic CAV and prognostic value for major adverse CV outcomes
Methodological detailsBayesian bivariate random-effects models
- Bayesian bivariate random-effects models
Pooled result
As reported in the abstract
Detection of significant CAV
| Group | Sensitivity | Specificity |
|---|---|---|
| Coronary CTA | 92.6% (95% CrI: 86.2%-96.2%) | 92.6% (95% CrI: 89.8%-94.9%) |
| PET | 83.9% (95% CrI: 69.1%-92.4%) | 89.6% (95% CrI: 82.2%-94.2%) |
Sensitivity
Coronary CTA92.6% (95% CrI: 86.2%-96.2%)
PET83.9% (95% CrI: 69.1%-92.4%)
Specificity
Coronary CTA92.6% (95% CrI: 89.8%-94.9%)
PET89.6% (95% CrI: 82.2%-94.2%)
Further pooled results
| Outcome | Coronary CTA |
|---|---|
| Detection of any CAVCrI | |
| Sensitivity | 97.6% (95% CrI: 93.7%-99.1%) |
| Specificity | 82.3% (95% CrI: 75.3%-88.3%) |
Prognosis: major adverse CV outcomes
- PET-derived parameters (myocardial flow reserve, stress myocardial blood flow, PET CAV score, summed stress score) predicted future major adverse CV outcomes
Original publication
Cardiac CT and PET for Surveillance of Heart Transplant Recipients: Systematic Review and Bayesian Meta-Analysis. JACC Cardiovasc Imaging. Published 30 July 2025. doi:10.
Summarised from the published abstract; every number is checked against it