Noninvasive Detection of Coronary Artery Stenoses with Contrast-Enhanced Whole-Heart Coronary Magnetic Resonance Angiography at 3.0 T

Chen, Zhiyong; Duan, Qing; Xue, Xunjing; Chen, Lianglong; Wenbin, Ye; Jin, Lixin; Sun, Bin

doi:10.1159/000323829

Cited by 11 publications

(9 citation statements)

References 48 publications

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“…By comparison, our study analyzed the left main coronary artery and the proximal, middle, and distal segments of 3 main vessels, and came out with similar diagnostic performance with the sensitivity, specificity, positive and negative predictive values of 92.3%, 96.7%, 83.7%, and 98.6% in segment-based analysis, and 100.0%, 66.7%, 92.3%, and 100.0% in patient-based analysis. Compared with previous studies 40–43 that reported the sensitivity, specificity, PPV, and NPV of 73%, 95%, 50%, and 98% in segment-based analysis by gadobutrol-enhanced CMRA, 40 and 93%, 42%, 70%, and 81% in patient-based analysis by noncontrast-enhanced CMRA, 6 our results showed the best diagnostic performance regarding all the parameters.…”

Section: Discussioncontrasting

confidence: 62%

Diagnostic Performance and Safety of a Novel Ferumoxytol-Enhanced Coronary Magnetic Resonance Angiography

Dong,

Si,

Zhu

et al. 2023

Circ: Cardiovascular Imaging

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BACKGROUND: Currently, noninvasive arteriography for the diagnosis of coronary artery disease is clinically limited to the computed tomography scanning, where patients have to be exposed to the radiation and risks associated with iodinated contrast. We aimed to investigate the diagnostic performance and safety of a novel ferumoxytol-enhanced coronary magnetic resonance angiography (CMRA) in patients with suspected coronary artery disease. METHODS: Thirty patients, 19 males, with a median age of 63 years old, and 17 with renal insufficiency, who were scheduled for invasive coronary angiography, were enrolled. Ferumoxytol was administered intravenously with a dose of 3 mg/kg during CMRA. Images were acquired with an ECG-triggered, navigator-gated, inversion recovery-prepared 3D fast low-angle shot sequence, and the image quality was assessed by a 4-point scale. Eighteen-segment coronary artery model was adopted to evaluate the visibility of the coronary arteries, and the image quality and stenosis were evaluated in nine segments. The diagnostic performance of CMRA is described as sensitivity, specificity, positive and negative predictive values, and accuracy with the invasive coronary angiography results as reference. The patients’ vital signs were monitored during CMRA, and their hepatic and renal functions were followed up for 3 months to evaluate the safety of ferumoxytol. RESULTS: Two hundred fifty-two of the 270 study segments were identified by CMRA, and their quality score reached 3.6±0.7. Referring to the invasive coronary angiography results, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ferumoxytol-enhanced CMRA reached 100.0%, 66.7%, 92.3%, 100.0%, and 93.3% respectively in patient-based analysis; 91.4%, 90.9%, 86.5%, 94.3%, and 91.1%, respectively in vessel-based analysis; and 92.3%, 96.7%, 83.7%, 98.6%, and 96.0%, respectively in segment-based analysis. No ferumoxytol-related adverse event was observed during the 3-month follow-up. CONCLUSIONS: Ferumoxytol-enhanced CMRA demonstrated good diagnostic performance and excellent safety in the diagnosis of significant coronary stenosis, providing an alternative to coronary computed tomography angiography for the diagnosis of coronary artery disease. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT05032937.

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Section: Discussioncontrasting

confidence: 62%

Diagnostic Performance and Safety of a Novel Ferumoxytol-Enhanced Coronary Magnetic Resonance Angiography

Dong,

Si,

Zhu

et al. 2023

Circ: Cardiovascular Imaging

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“…Yang et al [7] demonstrated the feasibility of accurate detection of significant stenosis in a singlecenter study. Initial experiments have shown that CE-CCMRA provides sufficiently high sensitivity and a negative predictive value to exclude significant stenosis in patients suspected of having CAD [29]. In addition, that study [29] suggested that image quality can be further improved by sublingual nitroglycerin and abdominal banding.…”

Section: Discussionmentioning

confidence: 99%

A direct comparison of 3 T contrast-enhanced whole-heart coronary cardiovascular magnetic resonance angiography to dual-source computed tomography angiography for detection of coronary artery stenosis: a single-center experience

Sun

Chen

Duan

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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Background In recent years, substantial advances have been made in noninvasive cardiac imaging, including cardiac computed tomography (CT) and cardiovascular magnetic resonance (CMR). The purpose of this study was to prospectively compare the diagnostic performance of contrast-enhanced whole heart coronary CMR angiography (CCMRA) to dual-source coronary CT angiography (CCTA) for the diagnosis of significant coronary stenoses (≥50%) in patients with known or suspected coronary artery disease (CAD) referred for conventional x-ray coronary angiography. Methods Our objective was to directly compare the diagnostic accuracy of contrast-enhanced whole-heart CCMRA (CE-CCMRA) to dual-source CCTA (DS-CCTA) for the detection of CAD. We prospectively studied 57 symptomatic patients with suspected or known CAD who were scheduled for conventional x-ray coronary angiography. Significant CAD was defined as an x-ray defined diameter reduction of ≥50% in a coronary artery with a reference diameter of ≥1.5 mm. Results CE-CCMRA and DS-CCTA were completed in 51 (89%) of 57 patients without complications. The acquisition times of CE-CCMRA and DS-CCTA, respectively, were 9.5 ± 3.1 min and 8.3 ± 1.4 s. On patient-based analysis, the sensitivity, specificity, positive and negative predictive value of CE-CCMRA and DS-CCTA were 93.5% versus 93.5%(P > 0.05), 85% versus 90%(P > 0.05), 90.6% versus 93.5%(P > 0.05), and 89.4% versus 90%(P > 0.05), respectively. The area under the curve (AUC) was 0.89 (95% CI: 0.79 to 0.99) for CE-CCMRA and 0.92 (95% CI: 0.83 to 1.00) for DS-CCTA. Conclusions DS-CCTA was found to be superior to CE-CCMRA in the diagnosis of significant coronary stenoses (≥50%) in patients with suspected or known CAD scheduled for conventional x-ray coronary angiography, owing to shorter scanning times and higher spatial resolution. However, CE-CCMRA and DS-CCTA have similar diagnostic accuracies.

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“…The publication years of these studies ranged from 2005 to 2022; 23 of these studies utilized 1.5 T MRI technology [ 13 – 25 , 28 , 30 , 31 , 33 – 37 , 44 – 46 ], while 11 utilized 3.0 T technology [ 26 , 27 , 29 , 32 , 38 – 43 , 45 ]. The countries of publication were diverse, with China having 11 reports [ 18 , 26 , 32 , 34 , 38 , 39 , 41 – 45 ], Germany having 8 reports [ 13 , 15 , 19 , 25 , 27 , 29 , 31 , 35 ], Japan having 7 reports [ 14 , 17 , 24 , 28 , 30 , 37 , 40 ], United Kingdom [ 21 , 46 ] having two reports and various other countries such as the United States [ 20 ], Korea [ 16 ], Switzerland [ 36 ], Portugal [ 33 ], Belgium [ 23 ], and Turkey [ 22 ] having one report each. In terms of study design, one study employed a prospective multicenter design [ 28 ], while 19 employed prospective single-center designs [ 13 – 15 , 17 , 21 , 23 , 25 – 27 , 29 – 32 , 37 – 39 , 43 – 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…The countries of publication were diverse, with China having 11 reports [ 18 , 26 , 32 , 34 , 38 , 39 , 41 – 45 ], Germany having 8 reports [ 13 , 15 , 19 , 25 , 27 , 29 , 31 , 35 ], Japan having 7 reports [ 14 , 17 , 24 , 28 , 30 , 37 , 40 ], United Kingdom [ 21 , 46 ] having two reports and various other countries such as the United States [ 20 ], Korea [ 16 ], Switzerland [ 36 ], Portugal [ 33 ], Belgium [ 23 ], and Turkey [ 22 ] having one report each. In terms of study design, one study employed a prospective multicenter design [ 28 ], while 19 employed prospective single-center designs [ 13 – 15 , 17 , 21 , 23 , 25 – 27 , 29 – 32 , 37 – 39 , 43 – 46 ]. The remaining studies were retrospective in nature.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of whole heart coronary magnetic resonance angiography: a systematic review and meta-analysis

Kato

Azuma

Nakayama

et al. 2023

Journal of Cardiovascular Magnetic Resonance

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Background The purpose of this meta-analysis was to comprehensively investigate the diagnostic ability of 1.5 T and 3.0 T whole heart coronary angiography (WHCA) to detect significant coronary artery disease (CAD) on X-ray coronary angiography. Methods A literature search of electronic databases, including PubMed, Web of Science Core Collection, Cochrane advanced search, and EMBASE, was performed to retrieve and integrate articles showing significant CAD detectability of 1.5 and 3.0 T WHCA. Results Data from 1899 patients from 34 studies were included in the meta-analysis. 1.5 T WHCA had a summary area under ROC of 0.88 in the patient-based analysis, 0.90 in the vessel-based analysis, and 0.92 in the segment-based analysis. These values for 3.0 T WHCA were 0.94, 0.95, 0.96, respectively. Contrast-enhanced 3.0 T WHCA had significantly higher specificity than non-contrast-enhanced 1.5 T WHCA on a patient-based analysis (0.87, 95% CI 0.80–0.92 vs. 0.74, 95% CI 0.64–0.82, P = 0.02). There were no differences in diagnostic performance on a patient-based analysis by use of vasodilators, beta-blockers or between Asian and Western countries. Conclusions The diagnostic performance of WHCA was deemed satisfactory, with contrast-enhanced 3.0 T WHCA exhibiting higher specificity compared to non-contrast-enhanced 1.5 T WHCA in a patient-based analysis. There were no significant differences in diagnostic performance on a patient-based analysis in terms of vasodilator or beta-blocker use, nor between Asian and Western countries. However, further large-scale multicentre studies are crucial for the widespread global adoption of WHCA.

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Noninvasive Detection of Coronary Artery Stenoses with Contrast-Enhanced Whole-Heart Coronary Magnetic Resonance Angiography at 3.0 T

Cited by 11 publications

References 48 publications

Diagnostic Performance and Safety of a Novel Ferumoxytol-Enhanced Coronary Magnetic Resonance Angiography

Diagnostic Performance and Safety of a Novel Ferumoxytol-Enhanced Coronary Magnetic Resonance Angiography

A direct comparison of 3 T contrast-enhanced whole-heart coronary cardiovascular magnetic resonance angiography to dual-source computed tomography angiography for detection of coronary artery stenosis: a single-center experience

Diagnostic accuracy of whole heart coronary magnetic resonance angiography: a systematic review and meta-analysis

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