Diagnostic Performance of 18F-FDG PET/CT in Native Valve Endocarditis: Systematic Review and Bivariate Meta-Analysis

Background: 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/compute...

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Published in:Diagnostics (Basel) 2020-09, Vol.10 (10), p.754
Main Authors: 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
Format: Article
Language:English
Subjects:
18F-FDG
Accuracy
diagnostic performance
Editorials
Endocarditis
infectious endocarditis
Meta-analysis
native valve endocarditis
Pathogens
Patients
PET/CT
positron emission tomography
Systematic review
Tomography
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Summary:Background: 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 (18F-FDG PET/CT) for the diagnosis of native valve endocarditis (NVE). Methods: Selected articles evaluating the diagnostic accuracy of 18F-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. Results: Seven studies (351 episodes of suspected NVE) were included. 18F-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 18F-FDG PET/CT in a multimodality strategy. Conclusions: In our systematic review and meta-analysis, 18F-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.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics10100754