diagnostic performance of f-18 fdg pet for detection of cardiac sarcoidosis; a systematic review and meta-analysis

The purpose of the current study was to investigate the diagnostic performance of f-18 fluorodeoxyglucose (fdg) positron emission tomography/computed tomography (pet/ct) for diagnosis of cardiac sarcoidosis (cs) through a systematic review and meta-analysis. the pubmed and embase database, from the earliest available date of indexing through 31 31, 2018, were searched for studies evaluating the diagnostic performance of f-18 fdg pet or pet/ct for cs. we determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (lr+ and lr−), and constructed summary receiver operating characteristic (sroc) curves. across 17 studies (891 patients), the pooled sensitivity was 0.84 [95% confidence interval (95% ci) 0.71-0.91] with heterogeneity (i2 = 77.5) and a pooled specificity of 0.83 (95% ci 0.74-0.89) with heterogeneity (i2 = 80.0). likelihood ratio (lr) syntheses gave an overall lr+ of 4.9 (95% ci 3.3-7.3) and lr− of 0.2 (95% ci 0.11-0.35). the pooled diagnostic odds ratio was 27 (95% ci 14-55). hierarchical sroc curve indicates that the area under the curve was 0.90 (95% ci 0.87-0.92). meta-regression showed that combined myocardial perfusion imaging was the source of heterogeneity. the current meta-analysis showed the moderate sensitivity and specificity of f-18 fdg pet or pet/ct for diagnosis of cs. the presence of combined myocardial perfusion imaging could improve diagnostic accuracy of f-18 fdg pet or pet/ct for diagnosis of cs. at present, the literature regarding the use of f-18 fdg pet for detection of cs remains limited; thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of f-18 fdg pet for diagnosis of cs.