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COMPARATIVE STUDY
JOURNAL ARTICLE

Comparing the Diagnostic Accuracies of F-18 Fluorodeoxyglucose Positron Emission Tomography and Magnetic Resonance Imaging for the Detection of Spondylodiscitis: A Meta-analysis

Seong-Jang Kim, Kyoungjune Pak, Keunyoung Kim, Jung Sub Lee
Spine 2019 April 1, 44 (7): E414-E422
30889146

STUDY DESIGN: A meta-analysis.

OBJECTIVE: The aim of this study was to compare the diagnostic accuracies of F-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) and magnetic resonance imaging (MRI) for the detection of spondylodiscitis through a meta-analysis.

SUMMARY OF BACKGROUND DATA: There is no meta-analysis study that compares the diagnostic accuracies of F-18 FDG PET and MRI for the detection of spondylodiscitis.

METHODS: The MEDLINE and EMBASE databases were searched from the earliest available date of indexing to January 10, 2018 for studies comparing the diagnostic performance F-18 FDG PET with that of MRI for the detection of spondylodiscitis. We determined the sensitivities and specificities across studies, calculated the positive and negative likelihood ratios (LR+ and LR-), and constructed the summary receiver operating characteristic curves.

RESULTS: In the seven studies (212 patients) selected, the pooled sensitivity and specificity of F-18 FDG PET were 0.95 (95% confidence interval [CI]: 0.87-0.98) and 0.88 (95% CI: 0.73-0.95), respectively. The LR syntheses showed an overall LR+ of 7.6 (95% CI: 3.4-17.2) and LR- of 0.05 (95% CI: 0.02-0.14). The pooled diagnostic odds ratio was 141 (95% CI: 44-444). The pooled sensitivity and specificity of MRI were 0.85 (95% CI: 0.65-0.95) and 0.66 (95% CI: 0.48-0.80), respectively. The LR syntheses showed an overall LR+ of 2.5 (95% CI: 1.5-4.2) and LR- of 0.22 (95% CI: 0.08-0.60). The pooled diagnostic odds ratio was 11 (95% CI: 3-42). In the meta-regression analysis, no variable was identified as the source of the study heterogeneity.

CONCLUSION: The current meta-analysis shows that F-18 FDG PET has better diagnostic accuracy than MRI for the detection of spondylodiscitis. Further large multicenter studies would be necessary to substantiate the diagnostic accuracies of F-18 FDG PET and MRI for spondylodiscitis.

LEVEL OF EVIDENCE: 2.

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