Diagnostic performance of F-18 FDG PET for detection of cardiac sarcoidosis; A systematic review and meta-analysis

• Published in: Journal of nuclear cardiology 2020-12, Vol.27 (6), p.2103-2115
• Main Authors: Kim, Seong-Jang, Pak, Kyoungjune, Kim, Keunyoung
• Format: Article
• Language: English
• Subjects: Cardiology; Cardiomyopathies - diagnostic imaging; diagnosis; F-18 FDG; Fluorodeoxyglucose F18; Humans; Imaging; Medical diagnosis; Medical imaging; Medicine; Medicine & Public Health; Meta-analysis; Myocarditis - diagnostic imaging; Nuclear Medicine; Original Article; PET/CT; Positron Emission Tomography Computed Tomography - methods; Positron-Emission Tomography - methods; Radiology; Radiopharmaceuticals; Reproducibility of Results; ROC Curve; Sarcoidosis; Sarcoidosis - diagnostic imaging; Sensitivity and Specificity; Systematic review; Tomography
• ISSN: 1071-3581; 1532-6551
• DOI: 10.1007/s12350-018-01582-y

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.