Diagnostic accuracy and utility of coronary CT angiography with consideration of unevaluable results: A systematic review and multivariate Bayesian random-effects meta-analysis with intention to diagnose

Objectives To meta-analyze diagnostic accuracy, test yield and utility of coronary computed tomography angiography (CCTA) in coronary artery disease (CAD) by an intention-to-diagnose approach with inclusion of unevaluable results. Methods Four databases were searched from 1/2005 to 3/2013 for prospective studies that used 16–320-row or dual-source CTs and provided 3 × 2 patient-level data of CCTA (positive, negative, or unevaluable) versus catheter angiography (positive or negative) for diagnosing ≥50 % coronary stenoses. A Bayesian multivariate 3 × 2 random-effects meta-analysis considered unevaluable CCTAs. Results Thirty studies (3422 patients) were included. Compared to 16–40 row CT, test yield and accuracy of CCTA has significantly increased with ≥64-row CT ( P