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Review
. 2025 Aug 7.
doi: 10.1007/s10554-025-03475-x. Online ahead of print.

Diagnostic accuracy of discovery NM 530c CZT SPECT for myocardial perfusion imaging in coronary artery disease: a systematic review and meta-analysis

Muhammad Arham  1 , Allah Dad  1 , Mohammad Hamza Bin Abdul Malik  2 , Talha Sajjad  1 , Muhammad Awais Bin  1 , Faseeh Haider  3 , Mishal Khan  4 , Anfal Hamza  1 , Muhammad Hammad Arif  5 , Muhammad Ahmad Qureshi  6 , Ali Bin Abdul Jabbar  7 , Muhammad Abdullah Javed  8 , Kinza Bakht  1
Affiliations
Review

Diagnostic accuracy of discovery NM 530c CZT SPECT for myocardial perfusion imaging in coronary artery disease: a systematic review and meta-analysis

Muhammad Arham et al. Int J Cardiovasc Imaging. .

Abstract

Coronary artery disease (CAD) is the leading cause of cardiovascular mortality (CVD), accounting for 1 in 5 CVD-related deaths. The advent of non-invasive imaging modalities has driven the use of myocardial perfusion imaging (MPI) to enhance diagnostic accuracy and improve clinical outcomes in CAD. Building on the role of myocardial perfusion imaging (MPI), this meta-analysis assesses the diagnostic accuracy of the Discovery NM 530c CZT SPECT for CAD compared with invasive coronary angiography (ICA ± FFR) and noninvasive modalities, including PET, MRI, and coronary CT angiography. A systematic search of six databases was conducted to identify studies evaluating the diagnostic accuracy of the NM 530c CZT-SPECT for detecting CAD. Comparator modalities included ICA ± FFR, PET, MRI, or coronary CTA performed within 90 days. Diagnostic performance was assessed using pooled sensitivity, specificity, summary receiver operating characteristic (SROC) curves, and diagnostic odds ratio (DOR), using R (v2024.12.0 + 467) with the "meta" and "mada" packages. A bivariate meta-analysis of 11 studies showed a pooled sensitivity of 83.5% (95% CI: 77.3-88.3%) and specificity of 75.8% (95% CI: 67.8-82.3%), with an AUC of 0.858 and diagnostic odds ratio (DOR) of 15.9. Likelihood ratios were 3.45 (positive) and 0.22 (negative). The SSS ≥ 4 subgroup showed the highest sensitivity (0.881) and DOR (19.21). The univariate random-effects model yielded a pooled sensitivity of 83% and specificity of 77%. Heterogeneity was moderate, and Deeks' test showed no publication bias (p = 0.83). This meta-analysis establishes the Discovery NM 530c CZT SPECT as a reliable and clinically effective non-invasive modality for detecting coronary artery disease (CAD), with a pooled sensitivity of 0.835, specificity of 0.758, and AUC of 0.858, supporting its diagnostic utility across diverse clinical settings.

Keywords: Coronary Artery Disease; Myocardial Perfusion Imaging; Single Photon Emission Computed Tomography Computed Tomography.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

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