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DOI: 10.1055/s-0042-123627
Die CE-MARC-Studien: Vom Saulus zum Paulus oder „Manchmal kommt es anders als man denkt“
The CE-MARC studies: “When Saul became Paul”Autoren
Publikationsverlauf
Publikationsdatum:
25. April 2017 (online)
Zusammenfassung
Die CE-MARC-Studie und die CE-MARC-2-Studie sind direkte bzw. indirekte Vergleichsstudien zwischen Myokard-SPECT-Untersuchungen und kardialer MRT. Nachdem die kardiale MRT die Myokard-SPECT in der Single-Center CE-MARC-Studie bez. Sensitivität und negativem prädiktiven Wert signifikant übertroffen hat, erfolgte die CE-MARC-2 Studie in einem multizentrischen Setting mit wesentlich besserer Myokard-SPECT-Technik als in der Initialstudie. Die Vorteile der kardialen MRT gegenüber der Myokard-SPECT aus der initialen Studie waren in der besser designten Folgestudie nicht mehr nachweisbar. Im Gegensatz zur ersten Studie schnitt die Myokard-SPECT in der CE-MARC-2 Studie in fast allen Parametern besser als die kardiale MRT ab, trotz ausschließlichem Einsatz von 3 Tesla MRT-Scannern.
Abstract
CE-MARC and CE-MARC 2 are high-ranking published studies comparing myocardial SPECT and cardiac MRI directly and indirectly resp. CE-MARC showed a superiority of cardiac MRI in comparison to myocardial SPECT concerning sensitivity and negative predictive value in a single center study design. The successive CE-MARC 2 study was designed and performed in a multi-center setting and with improved techniques concerning myocardial SPECT in comparison to the initial study. Advantages for cardiac MRI over SPECT shown in the initial CE-MARC study could not be obtained any more in the current CE-MARC-2 trial. Despite of using high-end 3 Tesla MRI scanner the performance of myocardial SPECT in the current CE-MARC-2 study was considerably better in comparison to cardiac MRI in almost all parameters.
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Literatur
- 1 Flotats A, Bengel FM, Knuuti J. et al. CMR versus SPECT for diagnosis of coronary heart disease. Lancet 2012; 379: 2145
- 2 Greenwood JP, Maredia N, Younger JF. et al. Cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary heart disease (CE-MARC): a prospective trial. Lancet 2012; 379: 453-460
- 3 Greenwood JP, Motwani M, Maredia N. et al. Comparison of cardiovascular magnetic resonance and single-photon emission computed tomography in women with suspected coronary artery disease from the Clinical Evaluation of Magnetic Resonance Imaging in Coronary Heart Disease (CE-MARC) Trial. Circulation 2014; 129: 1129-1138
- 4 Greenwood JP, Herzog BA, Brown JM. et al. Prognostic value of cardiovascular magnetic resonance and single-photon emission computed tomography in suspected coronary heart disease: long-term follow-up of a prospective, diagnostic accuracy cohort study. Ann Intern Med 2016; [Epub ahead of print]
- 5 Greenwood JP, Ripley DP, Berry C. et al. Effect of care guided by cardiovascular magnetic resonance, myocardial perfusion scintigraphy, or NICE guidelines on subsequent unnecessary angiography rates: the CE-MARC 2 randomized clinical trial. JAMA 2016; 316: 1051-1060
- 6 Ripley DP, Brown JM, Everett CC. et al. Rationale and design of the Clinical Evaluation of Magnetic Resonance Imaging in Coronary heart disease 2 trial (CE-MARC 2): a prospective, multicenter, randomized trial of diagnostic strategies in suspected coronary heart disease. Am Heart J 2015; 169: 17-24.e1
- 7 Schaefer WM, Knollmann D, Meyer PT. CMR versus SPECT for diagnosis of coronary heart disease. Lancet 2012; 379: 2146
- 8 Underwood R, Harbinson M, Kelion A. et al. CMR versus SPECT for diagnosis of coronary heart disease. Lancet 2012; 379: 2146