Kamani Christel H, Allenbach Gilles, Jreige Mario, Pavon Anna G, Meyer Marie, Testart Nathalie, Firsova Maria, Fernandes Vieira Victor, Boughdad Sarah, Nicod Lalonde Marie, Schaefer Niklaus, Guery Benoit, Monney Pierre, Prior John O, Treglia Giorgio
Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, CH-1011 Lausanne, Switzerland.
Department of Cardiology, Lausanne University Hospital, CH-1011 Lausanne, Switzerland.
Diagnostics (Basel). 2020 Sep 25;10(10):754. doi: 10.3390/diagnostics10100754.
Infectious endocarditis is a life-threatening disease, requiring prompt and accurate diagnosis. The aim of this article is to perform a systematic review and meta-analysis of the literature to estimate the performance of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) for the diagnosis of native valve endocarditis (NVE).
Selected articles evaluating the diagnostic accuracy of F-FDG PET/CT in patients with suspected NVE, resulting from a comprehensive literature search through the PubMed/MEDLINE and Cochrane library databases until April 2020, were included for the systematic review and meta-analysis.
Seven studies (351 episodes of suspected NVE) were included. F-FDG PET/CT yielded a pooled sensitivity of 36.3% and a pooled specificity of 99.1% for the diagnosis of NVE. The pooled positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 8.3, 0.6, and 15.3, respectively. The sensitivity increased using contemporary PET/CT device with state-of-the-art patient preparation as well as innovative image acquisitions or adding the results of F-FDG PET/CT in a multimodality strategy.
In our systematic review and meta-analysis, F-FDG PET/CT yielded a poor pooled sensitivity with an otherwise excellent pooled specificity for the diagnosis of NVE; however, several factors may increase the sensitivity without affecting the specificity and these factors should be better evaluated in future studies.
感染性心内膜炎是一种危及生命的疾病，需要及时准确的诊断。本文旨在对文献进行系统评价和荟萃分析，以评估氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）对天然瓣膜心内膜炎（NVE）的诊断效能。
通过检索PubMed/MEDLINE和Cochrane图书馆数据库，直至2020年4月，筛选出评估F-FDG PET/CT对疑似NVE患者诊断准确性的文章，纳入系统评价和荟萃分析。
纳入7项研究（351例疑似NVE病例）。F-FDG PET/CT诊断NVE的合并敏感度为36.3%，合并特异度为99.1%。合并阳性似然比、阴性似然比和诊断比值比分别为8.3、0.6和15.3。使用具有先进患者准备、创新图像采集的当代PET/CT设备，或在多模态策略中加入F-FDG PET/CT的结果，敏感度会提高。
在我们的系统评价和荟萃分析中，F-FDG PET/CT诊断NVE的合并敏感度较低，而合并特异度极佳；然而，一些因素可能会在不影响特异度的情况下提高敏感度，这些因素应在未来研究中得到更好的评估。
