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

A meta-analysis

Diagnostische Genauigkeit der 18F-FDG PET bzw. PET/CT für Vaskulitiden großer Gefäße

Eine Metaanalyse

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Abstract

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.

Zusammenfassung

Zielsetzung

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.

Methoden

Auf der Basis von Recherchen in PubMed, Embase und Cochrane-Datenbanken wurde zur diagnostischen Genauigkeit von 18F-FDG PET bzw. PET/CT bei Patienten mit Vaskulitiden großer Gefäße eine Metaanalyse publizierter Untersuchungen durchgeführt.

Ergebnisse

Insgesamt 8 Studien (n=400, 170 Vaskulitispatienten, 230 Kontrollen) wurden in die Metaanalyse einbezogen. Gepoolte Sensitivität und Spezifität der 18F-FDG-PET bzw. PET/CT betrugen 75,9 % (95 %-Konfidenzintervall, KI, 68,7–82,1) bzw. 93,0 % (95 %-KI 88,9–96,0). Die positive (PLR) bzw. negative Vorhersagewahrscheinlichkeit (NLR) und die diagnostische Odds Ratio (DOR) betrugen 7267 (95 %-KI 3,707–14,24), 0,303 (95 %-KI 0,229–0,400) und 32,04 (95 %-KI 13,08–78,45). Die Fläche unter der Kurve (AUC) lag bei 0,863 und der Q*-Index bei 0,794, somit war eine gute diagnostische Genauigkeit nachgewiesen. Für einen Schwelleneffekt gab es keinen Hinweis (Spearman-Korrelationskoeffizient  0,120, p = 0,776). Bezog man die Ergebnisse nur auf die Riesenzellarteriitis (GCA), lagen für 18F-FDG PET bzw. PET/CT die gepoolte Sensitivität und Spezifität bei 83,3 % (95 %-KI 72,1–91,4) und 89,6 % (95 %-KI 79,7–95,7). Die AUC betrug 0,884, der Q*-Index bei 0,815, was für eine mäßige Genauigkeit mit einer geringen Verbesserung der diagnostischen Genauigkeit spricht.

Schlussfolgerung

Anhand einer Metaanalyse wurde gezeigt, dass die 18F-FDG PET und die PET/CT eine gute diagnostische Genauigkeit für Vaskulitiden großer Gefäße haben und eine wesentliche Rolle in ihrer Diagnostik einnehmen.

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Compliance with ethical guidelines

Conflict of interest. Y.H. Lee, S.J. Choi, J.D. Ji, and G.G. Song state that there are no conflicts of interest.

The accompanying manuscript does not include studies on humans or animals.

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Authors and Affiliations

  1. Division of Rheumatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Korea University Medical Center, 73, Inchon-ro, Seongbuk-gu, 136-705, Seoul, South Korea

    Y.H. Lee MD, PhD, S.J. Choi, J.D. Ji & G.G. Song

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  1. Y.H. Lee MD, PhD
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  2. S.J. Choi
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  3. J.D. Ji
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  4. G.G. Song
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Correspondence to Y.H. Lee MD, PhD.

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Lee, Y., Choi, S., Ji, J. et al. Diagnostic accuracy of 18F-FDG PET or PET/CT for large vessel vasculitis. Z Rheumatol 75, 924–931 (2016). https://doi.org/10.1007/s00393-015-1674-2

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  • DOI: https://doi.org/10.1007/s00393-015-1674-2

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