Diagnostic performance of Fluorine-18-Fluorodeoxyglucose positron emission tomography in patients with chronic inflammatory bowel disease: a systematic review and a meta-analysis.

OBJECTIVE

To systematically review and meta-analyze published data about the diagnostic performance of Fluorine-18-Fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) and PET/computed tomography (PET/CT) in patients with chronic inflammatory bowel disease (IBD).

METHODS

A comprehensive computer literature search of studies published through May 2012 regarding (18)F-FDG-PET and PET/CT in patients with IBD was performed. All retrieved studies were reviewed and qualitatively analyzed. Pooled sensitivity, specificity, positive and negative likelihood ratio (LR+ and LR-) and diagnostic odd ratio (DOR) of (18)F-FDG PET and PET/CT in patients with IBD on a per segment-based analysis were calculated. The area under the ROC curve was calculated to measure the accuracy of (18)F-FDG PET and PET/CT in patients with IBD.

RESULTS

Nineteen studies comprising 454 patients with suspected IBD were included in the qualitative analysis (systematic review) and discussed. The quantitative analysis (meta-analysis) of seven selected studies (including 219 patients with IBD) provided the following results on a per segment-based analysis: sensitivity was 85% [95% confidence interval (95%CI) 81-88%], specificity 87% (95%CI 84-90%), LR+ 6.19 (95%CI: 2.86-13.41), LR- 0.19 (95%CI: 0.10-0.34), and DOR 44.35 (95%CI: 11.77-167.07). The area under the ROC curve was 0.933.

CONCLUSIONS

In patients with suspected IBD (18)F-FDG PET and PET/CT demonstrated good sensitivity and specificity, being accurate methods in this setting. Nevertheless, the literature focusing on the use of PET and PET/CT in IBD remains still limited; thus, further large multicenter studies will be necessary to substantiate the diagnostic accuracy of these methods in patients with IBD.