f-18 fdg pet for assessment of disease activity of large vessel vasculitis: a systematic review and meta-analysis

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. 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. 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. 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.