Study: MRI Superior to SPECT for Heart Disease

Cardiovascular MRI beats SPECT in diagnosing heart disease, according to the authors of a major British study published online on Dec. 23 in The Lancet.

A team led by John Greenwood, MD, of the Leeds General Infirmary recruited 752 patients at two British hospitals from March 2006 through August 2009 in a $2 million study funded by the British Health Foundation.

In the prospective trial, called CE-MARK, patients with suspected heart disease and at least one cardiovascular risk factor were given cardiovascular MRI, SPECT, and invasive x-ray coronary angiography.

The researchers considered the relative sensitivity, specificity, and predictive value (positive as well as negative) of MRI and SPECT. Coronary angiography showed significant coronary heart disease in 39 percent of the cohort.

The sensitivity of MRI (86.5 percent) was higher than that of SPECT (66.5 percent). Specificity (83.4 percent for MRI versus 82.6 percent for SPECT) and positive predictive value (77.2 percent for MRI vs. 71.4 percent for SPECT) were comparable. MRI outperformed SPECT in negative predictive value (90.5 percent vs. 79.1 percent).

In view of what they described as cardiovascular MRI’s “superiority over SPECT,” Greenwood and colleagues concluded that cardiovascular MRI “should be adopted more widely than at present for the investigation of coronary heart disease.”