Diagnostic accuracy of 18F-FDG PET or PET/CT for large vessel vasculitis A meta-analysis

• Published in: Zeitschrift für Rheumatologie Vol. 75; no. 9; pp. 924 - 931
• Main Authors: Lee, Y.H., Choi, S.J., Ji, J.D., Song, G.G.
• Format: Journal Article
• Language: English
• Published: Munich Springer Medizin 01.11.2016
• Subjects: Adult; Aged; Aged, 80 and over; Arteritis - diagnostic imaging; Arteritis - epidemiology; Diagnosis, Differential; Early Diagnosis; Female; Fluorodeoxyglucose F18; Humans; Immunology; Internal Medicine; Laboratory Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Originalien; Orthopedics; Positron Emission Tomography Computed Tomography - utilization; Positron-Emission Tomography - utilization; Prevalence; Reproducibility of Results; Rheumatology; Risk Factors; Sensitivity and Specificity; Riesenzellarteriitis; Spezifität; Sensitivität; Sensitivity; Specificity; Imaging; Bildgebung; Giant cell arteritis; Takayasu arteritis; Takayasu-Arteriitis
• ISSN: 0340-1855; 1435-1250; 1435-1250
• DOI: 10.1007/s00393-015-1674-2

Objective The purpose of this study was to evaluate the diagnostic performance of 18F-fluorodeoxyglucose positron-emission tomography (18F-FDG PET) or positron-emission tomography/computed tomography (PET/CT) for patients with large vessel vasculitis. Methods Based on a search in the PubMed, Embase, and Cochrane Library databases, a meta-analysis was performed on the diagnostic accuracy of 18F-FDG PET or PET/CT in patients with large vessel vasculitis. Results A total of eight studies involving 400 subjects (170 vasculitis patients and 230 controls) were selected for meta-analysis. The pooled sensitivity and specificity of 18F-FDG PET or PET/CT were 75.9 % (95 % confidence interval, CI 68.7–82.1) and 93.0 % (95 % CI 88.9–96.0), respectively. The positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were 7.267 (95 % CI 3.707–14.24), 0.303 (95 % CI 0.229–0.400), and 32.04 (95 % CI 13.08–78.45), respectively. The area under the curve (AUC) was 0.863 and the Q * index 0.794, indicating good diagnostic accuracy. There was no evidence of a threshold effect (Spearman’s correlation coefficient = 0.120, p = 0.776). When the data were limited to giant cell arteritis (GCA), the pooled sensitivity and specificity of 18F-FDG PET or PET/CT were 83.3 % (95 % CI 72.1–91.4) and 89.6 % (95 % CI 79.7–95.7), respectively; AUC was 0.884, and the Q * index 0.815, indicating modest accuracy with a small increase in diagnostic accuracy. Conclusion This meta-analysis of published studies demonstrates that 18F-FDG PET or PET/CT has good diagnostic accuracy for large vessel vasculitis and plays an important role in the diagnosis of this condition.