Diagnostic performance of 18F-FDG PET or PET/CT for detection of myocarditis.

Objective: The purpose of the current study was to evaluatethe diagnostic accuracies of fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET) or PET/computed tomography (CT) for diagnosis of myocarditis through and a meta-analysis.

Materials and methods: The PubMed, Cochrane database, and Embase database were searched from inception through November 30, 2022 for studies evaluating diagnostic performance of ¹⁸F-FDG PET or PET/CT for diagnosis of acute myocarditis. Based on data extracted from patient-based analysis, we calculated the pooled sensitivity and specificity with the 95% confidence intervals (CI). Also, we calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic curves.

Results: Across 5 studies (6 results, 264 patients), the pooled sensitivity of ¹⁸F-FDG PET or PET/CT was 0.57 (95% CI; 0.26-0.84) and a pooled specificity of 0.89 (95% CI; 0.74-0.96). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 5.1 and negative likelihood ratio (LR-) of 0.48. The pooled DOR was 11 (95% CI; 2-47). In meta-regression analysis, no variable was the source of the study heterogeneity.

Conclusion: Fluorine-18-FDG PET or PET/CT showed insufficient sensitivityand moderate specificity for diagnosis of myocarditis. These results indicated that cautious application of ¹⁸F-FDG PET or PET/CT should be paid for detection of myocarditis.