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A Systematic Review and Meta-Analysis on the Accuracy of Fluorodeoxyglucose Positron Emission Tomography/
Mei Hu1, Guangwen Chen1, Lin Luo1
1Department of Radiology, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Sciences, Chengdu, China.
Objective:
Fluorodeoxyglucose Positron emission tomography/computerized tomography (FDG PET/CT) has become popular for diagnosing periprosthetic joint infections (PJI). However, the diagnostic accuracy for this technique has varied from report to report. This meta-analysis was performed to assess the accuracy of FDG PET/CT for PJI diagnosis.
Material And Methods:
We conducted a systematic search of online academic databases for all studies reporting the diagnostic accuracy of FDG PET/CT for PJI. Meta-analysis was performed using STATA software.
Results:
23 studies, containing data on 1,437 patients, met inclusion criteria. Pooled sensitivity and specificity of FDG PET/CT for diagnosing PJI were 85% (95% CI, 76%, 91%) and 86% (95% CI, 78%, 91%), respectively with an AUC of 0.92. LRP was 6.1 (95% CI, 3.8, 9.7) and LRN was 0.17 (0.11, 0.28), indicating that FDG PET/CT cannot be used for confirmation or exclusion of PJI. There was significant inter-study heterogeneity, but no significant publication bias was noted.
Conclusions:
Our study found that FDG PET/CT has an important role as a diagnostic tool for PJI with high sensitivity and specificity. Further studies exploring its accuracy in different PJI locations remain necessary.
Insights
Fluorodeoxyglucose Positron Emission Tomography/Computerized Tomography (FDG PET/CT) shows high accuracy in diagnosing periprosthetic joint infections (PJI). While not definitive for confirmation or exclusion, it
Area of Science:
- Medical Imaging
- Nuclear Medicine
- Orthopedic Surgery
Background:
- Periprosthetic joint infection (PJI) diagnosis can be challenging.
- Fluorodeoxyglucose Positron Emission Tomography/Computerized Tomography (FDG PET/CT) is increasingly utilized for PJI detection.
- Existing reports show variable diagnostic accuracy for FDG PET/CT in PJI.
Purpose of the Study:
- To systematically assess the diagnostic accuracy of FDG PET/CT for periprosthetic joint infections (PJI).
- To provide pooled estimates of sensitivity, specificity, and other diagnostic metrics for FDG PET/CT in PJI.
Main Methods:
- A systematic literature search was conducted across major academic databases.
- Studies reporting diagnostic accuracy of FDG PET/CT for PJI were included.
- Meta-analysis was performed using STATA software to pool data from 23 studies involving 1,437 patients.
Main Results:
- Pooled sensitivity for FDG PET/CT in PJI diagnosis was 85% (95% CI, 76%-91%) and pooled specificity was 86% (95% CI, 78%-91%).
- The area under the curve (AUC) was 0.92, with a positive likelihood ratio (LRP) of 6.1 and a negative likelihood ratio (LRN) of 0.17.
- Significant inter-study heterogeneity was observed, but no significant publication bias was detected.
Conclusions:
- FDG PET/CT demonstrates significant value as a diagnostic tool for PJI, exhibiting high sensitivity and specificity.
- Despite its accuracy, FDG PET/CT results should be interpreted cautiously as they may not definitively confirm or exclude PJI.
- Further research is needed to evaluate FDG PET/CT accuracy across various PJI locations.
