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F-18 FDG PET for assessment of disease activity of large vessel vasculitis: A systematic review and meta-analysis

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The aim of this study is to investigate the performance of F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) or positron emission tomography/computed tomography (PET/CT) for the assessment of disease activity in patients with large vessel vasculitis (LVV) through a meta-analysis.

Methods

The MEDLINE via PubMed and EMBASE were searched for the studies evaluating the performance of F-18 FDG PET or PET/CT in the assessment of disease activity in patients with LVV. Pooled sensitivity, specificity, diagnostic odds ratios (DORs), and summary receiver-operating characteristic (sROC) curve were estimated across the included studies. Possible publication bias was assessed by Deek’s funnel plot asymmetry tests.

Results

A total of 439 PET images from 298 patients pooled from nine studies showed that the pooled sensitivity was 0.88 [95% confidence interval (CI) 0.79-0.93] without heterogeneity (χ2 = 14.42, P = .07) and the pooled specificity was 0.81 (95% CI 0.64-0.91) with heterogeneity (χ2 = 63.72, P = .00) for the detection of active LVV. The pooled DOR was 30 (95% CI 8-107). Hierarchical sROC curve indicates that the area under the curve was 0.91 (95% CI 0.89-0.94). There was no significant publication bias (P = .42), and meta-regression analysis revealed that none of the variables was the source of the study heterogeneity.

Conclusions

F-18 FDG PET has a good performance for the detection of active disease status in patients with LVV. Revised criteria for the assessment of disease activity incorporated with F-18 FDG PET or PET/CT should be introduced and validated. Further studies are warranted to determine if PET-based treatment of LVV can improve outcomes.

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Abbreviations

DORs:

Diagnostic odds ratios

ESR:

Erythrocyte sedimentation rates

FDG:

Fluorodeoxyglucose

GCA:

Giant cell arteritis

LVV:

Large vessel vasculitis

PET:

Positron emission tomography

PET/CT:

Positron emission tomography/computed tomography

SUVmax :

Maximum standardized uptake value

TA:

Takayasu’s arteritis

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Disclosure

The authors of this manuscript declare no relationships with any companies products or services of which may be related to the subject matter of the article.

Informed Consent

Written informed consent was not required for this study because it is a meta-analysis based on the studies that have been published.

Ethical Approval

Institutional Review Board approval was not required because only the published studies were used in this meta-analysis. The manuscript has not been published before and is not under consideration for publication anywhere else.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Taegu, South Korea

    Sang-Woo Lee MD, PhD, Shin Young Jeong MD, PhD, Byeong-Cheol Ahn MD, PhD & Jaetae Lee MD, PhD

  2. Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan, 50612, South Korea

    Seong-Jang Kim MD, PhD

  3. BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, 50612, South Korea

    Seong-Jang Kim MD, PhD

  4. Department of Nuclear Medicine, Busan Seongso Hospital, Pusan, South Korea

    Youngduk Seo MD, PhD

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  1. Sang-Woo Lee MD, PhD
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  4. Shin Young Jeong MD, PhD
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Correspondence to Seong-Jang Kim MD, PhD.

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Funding

This work was supported by a Grant of the Korea Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (Grant Number HI16C1501).

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Lee, SW., Kim, SJ., Seo, Y. et al. F-18 FDG PET for assessment of disease activity of large vessel vasculitis: A systematic review and meta-analysis. J. Nucl. Cardiol. 26, 59–67 (2019). https://doi.org/10.1007/s12350-018-1406-5

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  • DOI: https://doi.org/10.1007/s12350-018-1406-5

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