Lower extremity arterial disease: multidetector CT angiography meta-analysis

Area of Science:

• Vascular Imaging
• Radiology
• Diagnostic Performance Evaluation

Background:

• Symptomatic lower extremity arterial disease requires accurate diagnostic methods.
• Digital subtraction angiography (DSA) is the reference standard but is invasive.
• Multidetector computed tomographic (CT) angiography offers a non-invasive alternative.

Purpose of the Study:

• To estimate the diagnostic performance of multidetector CT angiography versus DSA.
• To identify factors influencing diagnostic performance variations between studies.

Main Methods:

• Systematic review of studies (2000-2006) comparing multidetector CT angiography and DSA.
• Inclusion criteria: studies enabling 2x2 contingency tables for >=50% stenosis detection.
• Random-effects summary receiver operating characteristic analysis was used.

Main Results:

• 12 studies evaluated 9541 arterial segments in 436 patients.
• Pooled sensitivity: 92% (95% CI: 89%-95%); Pooled specificity: 93% (95% CI: 91%-95%).
• Performance was consistent across aortoiliac, femoropopliteal, and infrapopliteal tracts.

Conclusions:

• Multidetector CT angiography is an accurate diagnostic test for lower extremity arterial disease (>=50% stenosis).
• It provides reliable assessment of the entire lower extremity arterial tree.