Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan, 50612, Korea.
BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, 50612, Korea.
J Nucl Cardiol. 2020 Dec;27(6):2103-2115. doi: 10.1007/s12350-018-01582-y. Epub 2019 Jan 2.
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 (I = 77.5) and a pooled specificity of 0.83 (95% CI 0.74-0.89) with heterogeneity (I = 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.
本研究通过系统评价和荟萃分析旨在探讨 F-18 氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）在诊断心脏结节病（CS）中的诊断性能。
检索了 PubMed 和 EMBASE 数据库，检索时间从最早可检索日期至 2018 年 3 月 31 日，以评估 F-18 FDG PET 或 PET/CT 用于 CS 诊断的研究。我们在研究之间确定了敏感性和特异性，计算了阳性和阴性似然比（LR+和 LR-），并构建了汇总受试者工作特征（SROC）曲线。
在 17 项研究（891 例患者）中，汇总敏感性为 0.84（95%置信区间[95%CI]为 0.71-0.91），存在异质性（I=77.5%），汇总特异性为 0.83（95%CI 为 0.74-0.89），存在异质性（I=80.0%）。似然比（LR）综合分析得出总体 LR+为 4.9（95%CI 为 3.3-7.3），LR-为 0.2（95%CI 为 0.11-0.35）。汇总诊断优势比为 27（95%CI 为 14-55）。层次 SROC 曲线表明曲线下面积为 0.90（95%CI 为 0.87-0.92）。Meta 回归显示，合并心肌灌注成像为异质性的来源。
本荟萃分析显示，F-18 FDG PET 或 PET/CT 对 CS 的诊断具有中等敏感性和特异性。合并心肌灌注成像可提高 F-18 FDG PET 或 PET/CT 对 CS 诊断的准确性。目前，有关 F-18 FDG PET 用于检测 CS 的文献仍然有限；因此，需要进一步进行大型多中心研究以证实 F-18 FDG PET 对 CS 诊断的准确性。
