Giorgio Treglia1,2,3, Mariarosa Pascale4, Elena Lazzeri5, Wouter van der Bruggen6, Roberto C Delgado Bolton7, Andor W J M Glaudemans8. 1. Clinic of Nuclear Medicine and PET/CT Center, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona and Lugano, Switzerland. giorgio.treglia@eoc.ch. 2. Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. giorgio.treglia@eoc.ch. 3. Health Technology Assessment Unit, Academic Education, Research and Innovation Area, Ente Ospedaliero Cantonale, Via Lugano 4F, CH-6500, Bellinzona, Switzerland. giorgio.treglia@eoc.ch. 4. Clinical Trial Unit, Ente Ospedaliero Cantonale, Bellinzona, Switzerland. 5. Regional Center of Nuclear Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. 6. Department of Radiology and Nuclear Medicine, Slingeland Hospital, Doetinchem, The Netherlands. 7. Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, San Pedro University Hospital and Centre for Biomedical Research of La Rioja (CIBIR), Logroño, La Rioja, Spain. 8. Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Abstract
PURPOSE: Diagnosis of spinal infection (SI) is challenging and usually requires multiple tests. We aimed to perform a systematic review and a bivariate meta-analysis on the diagnostic role of 18F-FDG PET/CT in patients with SI. METHODS: A comprehensive literature search of studies published through February 2019 in PubMed/MEDLINE and Cochrane library databases was carried out. Studies investigating the diagnostic performance of 18F-FDG PET/CT in patients with SI were eligible for inclusion in the qualitative analysis. For the quantitative analysis, pooled sensitivity, specificity, positive and negative likelihood ratio (LR+ and LR-) and diagnostic odds ratio (DOR) of 18F-FDG PET/CT in patients with suspected SI were calculated on a per examination-based analysis. Pooled data were presented with 95% confidence intervals (95% CI). RESULTS: Twenty-six articles (833 patients) using 18F-FDG PET/CT were eligible for the qualitative analysis. Twelve studies (396 patients) were selected for the meta-analysis. Overall, 18F-FDG PET/CT demonstrated a very good diagnostic performance in patients with SI and several studies underlined the value of 18F-FDG PET/CT in assessing the response to treatment. The bivariate meta-analysis on 18F-FDG PET/CT in patients with suspected SI provided the following results: sensitivity 94.8% (95% CI 88.9-97.6%) and specificity 91.4% (95% CI 78.2-96.9%). The pooled LR+, LR- and DOR were 4.7 (95% CI 2.9-7.7), 0.11 (95% CI 0.07-0.16) and 63.4 (95% CI 28.9-139), respectively. No significant heterogeneity or publication bias was found. CONCLUSION: 18F-FDG PET/CT demonstrated a very good diagnostic performance in patients with SI and can be used in patients in which MRI cannot be performed or is non-diagnostic or inconclusive. Several studies underlined the value of 18F-FDG PET/CT in assessing the response to treatment in patients with SI. Overall, larger multicentre and prospective studies and cost-effectiveness analyses are warranted.
PURPOSE: Diagnosis of spinal infection (SI) is challenging and usually requires multiple tests. We aimed to perform a systematic review and a bivariate meta-analysis on the diagnostic role of 18F-FDG PET/CT in patients with SI. METHODS: A comprehensive literature search of studies published through February 2019 in PubMed/MEDLINE and Cochrane library databases was carried out. Studies investigating the diagnostic performance of 18F-FDG PET/CT in patients with SI were eligible for inclusion in the qualitative analysis. For the quantitative analysis, pooled sensitivity, specificity, positive and negative likelihood ratio (LR+ and LR-) and diagnostic odds ratio (DOR) of 18F-FDG PET/CT in patients with suspected SI were calculated on a per examination-based analysis. Pooled data were presented with 95% confidence intervals (95% CI). RESULTS: Twenty-six articles (833 patients) using 18F-FDG PET/CT were eligible for the qualitative analysis. Twelve studies (396 patients) were selected for the meta-analysis. Overall, 18F-FDG PET/CT demonstrated a very good diagnostic performance in patients with SI and several studies underlined the value of 18F-FDG PET/CT in assessing the response to treatment. The bivariate meta-analysis on 18F-FDG PET/CT in patients with suspected SI provided the following results: sensitivity 94.8% (95% CI 88.9-97.6%) and specificity 91.4% (95% CI 78.2-96.9%). The pooled LR+, LR- and DOR were 4.7 (95% CI 2.9-7.7), 0.11 (95% CI 0.07-0.16) and 63.4 (95% CI 28.9-139), respectively. No significant heterogeneity or publication bias was found. CONCLUSION:18F-FDG PET/CT demonstrated a very good diagnostic performance in patients with SI and can be used in patients in which MRI cannot be performed or is non-diagnostic or inconclusive. Several studies underlined the value of 18F-FDG PET/CT in assessing the response to treatment in patients with SI. Overall, larger multicentre and prospective studies and cost-effectiveness analyses are warranted.
Authors: Michael L Prodromou; Panayiotis D Ziakas; Loukia S Poulou; Petros Karsaliakos; Loukas Thanos; Eleftherios Mylonakis Journal: Clin Nucl Med Date: 2014-04 Impact factor: 7.794
Authors: Matthew D F McInnes; David Moher; Brett D Thombs; Trevor A McGrath; Patrick M Bossuyt; Tammy Clifford; Jérémie F Cohen; Jonathan J Deeks; Constantine Gatsonis; Lotty Hooft; Harriet A Hunt; Christopher J Hyde; Daniël A Korevaar; Mariska M G Leeflang; Petra Macaskill; Johannes B Reitsma; Rachel Rodin; Anne W S Rutjes; Jean-Paul Salameh; Adrienne Stevens; Yemisi Takwoingi; Marcello Tonelli; Laura Weeks; Penny Whiting; Brian H Willis Journal: JAMA Date: 2018-01-23 Impact factor: 56.272
Authors: Jason F Talbott; Vinil N Shah; Alina Uzelac; Jared Narvid; Rebecca A Dumont; Cynthia T Chin; David M Wilson Journal: Semin Ultrasound CT MR Date: 2018-09-26 Impact factor: 1.875
Authors: F-A Dauchy; A Dutertre; S Lawson-Ayayi; H de Clermont-Gallerande; C Fournier; P Zanotti-Fregonara; H Dutronc; J-M Vital; M Dupon; P Fernandez Journal: Clin Microbiol Infect Date: 2016-01-21 Impact factor: 8.067
Authors: Christopher Palestro; Alicia Clark; Erin Grady; Sherif Heiba; Ora Israel; Alan Klitzke; Charito Love; Mike Sathekge; S Ted Treves; Tracy L Yarbrough Journal: J Nucl Med Date: 2021-09-30 Impact factor: 11.082