Diagnostic accuracy of photon-counting computed tomography for detecting coronary artery stenosis: a systematic review and meta-analysis
Authors' conclusion
PCCT demonstrates consistently high sensitivity and moderate-to-high specificity for detecting coronary artery stenosis at patient, vessel and segment levels, with improved performance in heavily calcified disease compared with conventional CCTA. These findings support current first-generation PCCT as a high-confidence non-invasive rule-out modality. By mitigating artefacts in complex anatomies, PCCT demonstrates potential to reduce unnecessary invasive angiography, warranting further validation in multivendor, large-scale trials.
Study context
- Population
- Prospective and retrospective studies evaluating Photon-counting CT (PCCT) for detection of coronary artery stenosis19 studies in qualitative synthesis, 10 in quantitative meta-analysis (of 1010 records identified) · qualitative synthesis 19 · quantitative meta-analysis 10
- Comparison
- PCCT for detection of coronary artery stenosis
- Outcome
- Pooled diagnostic accuracy for coronary artery stenosis
Methodological detailsregistered prospectively in PROSPERO, bivariate random-effects model
- Registered prospectively in PROSPERO
- Bivariate random-effects model
Pooled result
As reported in the abstract
| Group | Sensitivity | Specificity |
|---|---|---|
| PCCT, patient level | 94.5% | 81.8% |
| PCCT, vessel level | 95.1% | 89.2% |
| PCCT, segment level | 95.2% | 94.7% |
Sensitivity
Specificity
Further pooled results
Heterogeneity
- Heterogeneity was moderate, particularly for specificity
Publication bias
- Deeks’ funnel plot showed no evidence of significant publication bias
- Non-independence of vessel-level and segment-level data may have led to overestimation of precision.
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Original publication
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