Diagnostic performance of F-18 FDG PET for detection of cardiac sarcoidosis; A systematic review and meta-analysis
The purpose of the current study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for diagnosis of cardiac sarcoidosis (CS) through a systematic review and meta-analysis.
The PubMed and EMBASE database, from the earliest available date of indexing through 31 March 31, 2018, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT for CS. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR−), and constructed summary receiver operating characteristic (SROC) curves.
Across 17 studies (891 patients), the pooled sensitivity was 0.84 [95% confidence interval (95% CI) 0.71-0.91] with heterogeneity (I2 = 77.5) and a pooled specificity of 0.83 (95% CI 0.74-0.89) with heterogeneity (I2 = 80.0). Likelihood ratio (LR) syntheses gave an overall LR+ of 4.9 (95% CI 3.3-7.3) and LR− of 0.2 (95% CI 0.11-0.35). The pooled diagnostic odds ratio was 27 (95% CI 14-55). Hierarchical SROC curve indicates that the area under the curve was 0.90 (95% CI 0.87-0.92). Meta-regression showed that combined myocardial perfusion imaging was the source of heterogeneity.
The current meta-analysis showed the moderate sensitivity and specificity of F-18 FDG PET or PET/CT for diagnosis of CS. The presence of combined myocardial perfusion imaging could improve diagnostic accuracy of F-18 FDG PET or PET/CT for diagnosis of CS. At present, the literature regarding the use of F-18 FDG PET for detection of CS remains limited; thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of F-18 FDG PET for diagnosis of CS.
KeywordsF-18 FDG PET/CT sarcoidosis diagnosis
Diagnostic odds ratio
Japanese Ministry of Health and Welfare
Positron emission tomography
Positron emission tomography/computed tomography
Maximum standardized uptake value
Protocol/project development: Kim SJ, Pak K. Data collection or management: Kim SJ, Kim K, Pak K. Data analysis: Kim SJ, Kim K. Manuscript writing/editing; Kim SJ, Pak K, and Kim K.
The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of this study.
Institutional Review Board approval was not required because we only performed data analysis based on the published studies.
Written informed consent was not required for this study because it is a meta-analysis based on the studies that have been published.
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