Diagnostic performance of <sup>18</sup>F-FDG PET/CT in patients with spinal infection: a systematic review and a bivariate meta-analysis.
meta_analysis · Level I
Where this comes from
- Record sourced from PubMed, PMID 31729539.
- Also identified by DOI 10.1007/s00259-019-04571-6.
- No licence information is recorded for this record.
- Because redistribution is not established, this page shows the abstract only. Follow the links below for the full text.
Abstract
Diagnosis of spinal infection (SI) is challenging and usually requires multiple tests. We aimed to perform a systematic review and a bivariate meta-analysis on the diagnostic role of <sup>18</sup>F-FDG PET/CT in patients with SI. A comprehensive literature search of studies published through February 2019 in PubMed/MEDLINE and Cochrane library databases was carried out. Studies investigating the diagnostic performance of <sup>18</sup>F-FDG PET/CT in patients with SI were eligible for inclusion in the qualitative analysis. For the quantitative analysis, pooled sensitivity, specificity, positive and negative likelihood ratio (LR+ and LR-) and diagnostic odds ratio (DOR) of <sup>18</sup>F-FDG PET/CT in patients with suspected SI were calculated on a per examination-based analysis. Pooled data were presented with 95% confidence intervals (95% CI). Twenty-six articles (833 patients) using <sup>18</sup>F-FDG PET/CT were eligible for the qualitative analysis. Twelve studies (396 patients) were selected for the meta-analysis. Overall, <sup>18</sup>F-FDG PET/CT demonstrated a very good diagnostic performance in patients with SI and several studies underlined the value of <sup>18</sup>F-FDG PET/CT in assessing the response to treatment. The bivariate meta-analysis on <sup>18</sup>F-FDG PET/CT in patients with suspected SI provided the following results: sensitivity 94.8% (95% CI 88.9-97.6%) and specificity 91.4% (95% CI 78.2-96.9%). The pooled LR+, LR- and DOR were 4.7 (95% CI 2.9-7.7), 0.11 (95% CI 0.07-0.16) and 63.4 (95% CI 28.9-139), respectively. No significant heterogeneity or publication bias was found. <sup>18</sup>F-FDG PET/CT demonstrated a very good diagnostic performance in patients with SI and can be used in patients in which MRI cannot be performed or is non-diagnostic or inconclusive. Several studies underlined the value of <sup>18</sup>F-FDG PET/CT in assessing the response to treatment in patients with SI. Overall, larger multicentre and prospective studies and cost-effectiveness analyses are warranted.
Medical subject headings
- Fluorodeoxyglucose F18
- Positron Emission Tomography Computed Tomography