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Diagnostic performance of F-18 fluorodeoxyglucose PET/computed tomography for diagnosis of polymyalgia rheumatica: a
Keunyoung Kim1, Seong-Jang Kim2,3,4
1Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan.
Objective:
The purpose of the current study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) PET/computed tomography (CT) for diagnosis of polymyalgia rheumatic (PMR) through a meta-analysis.
Methods:
The PubMed, Cochrane and EMBASE database, from the earliest available date of indexing up to 29 February 2020, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for diagnosis of PMR.
Results:
Across the 11 results of seven studies selected for analysis (684 patients), the pooled sensitivity for F-18 FDG PET/CT was 0.76 [95% confidence interval (CI), 0.67-0.83] with heterogeneity (I = 74.9, P < 0.001) and a pooled specificity of 0.87 (95% CI, 0.82-0.91) with heterogeneity (I = 61.2, P < 0.001). Likelihood ratio syntheses gave an overall positive likelihood ratio of 5.7 (95% CI, 4.3-7.7) and negative likelihood ratio of 0.28 (95% CI, 0.2-0.38). The pooled diagnostic odds ratio was 21 (95% CI, 13-32). The hierarchical summary receiver operating characteristic curve indicated the areas under the curve as 0.93 (95% CI, 0.90-0.95).
Conclusion:
The current meta-analysis showed a moderate sensitivity and specificity of F-18 FDG PET/CT for the diagnosis of PMR. Currently, the literature on the use of F-18 PET/CT for the diagnosis of PMR is limited. Thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of F-18 FDG PET/CT for the detection of PMR.
Insights
F-18 FDG PET/CT shows moderate diagnostic performance for polymyalgia rheumatic (PMR). Further multicenter studies are needed to confirm the accuracy of F-18 FDG PET/CT in detecting PMR.
Area of Science:
- Nuclear Medicine
- Diagnostic Imaging
- Rheumatology
Background:
- Polymyalgia rheumatic (PMR) is an inflammatory condition affecting older adults.
- Accurate diagnosis of PMR is crucial for timely treatment and preventing complications.
Purpose of the Study:
- To evaluate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) PET/computed tomography (CT) for diagnosing PMR.
- To synthesize existing evidence through a meta-analysis.
Main Methods:
- Systematic search of PubMed, Cochrane, and EMBASE databases up to February 29, 2020.
- Meta-analysis of seven studies including 684 patients to assess diagnostic accuracy.
- Calculation of pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratio.
Main Results:
- Pooled sensitivity for F-18 FDG PET/CT in PMR diagnosis was 0.76 (95% CI, 0.67-0.83).
- Pooled specificity was 0.87 (95% CI, 0.82-0.91).
- Area under the hierarchical summary receiver operating characteristic curve was 0.93 (95% CI, 0.90-0.95).
Conclusions:
- F-18 FDG PET/CT demonstrates moderate sensitivity and specificity for PMR diagnosis.
- Current literature on F-18 FDG PET/CT for PMR is limited.
- Larger multicenter studies are recommended to further validate its diagnostic accuracy.
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