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Diagnostic Performance of PET or PET/CT Using 18F-FDG Labeled White Blood Cells in Infectious Diseases: A Systematic Review and a Bivariate Meta-Analysis

1
Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, CH-1011 Lausanne, Switzerland
2
Department of Internal Medicine, Ente Ospedaliero Cantonale, CH-6500 Bellinzona, Switzerland
3
Clinic of Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, CH-6500 Bellinzona, Switzerland
4
Health Technology Assessment Unit, Ente Ospedaliero Cantonale, CH-6500 Bellinzona, Switzerland
*
Author to whom correspondence should be addressed.
These authors share the last authorship.
Diagnostics 2019, 9(2), 60; https://doi.org/10.3390/diagnostics9020060
Received: 29 May 2019 / Revised: 11 June 2019 / Accepted: 14 June 2019 / Published: 15 June 2019
(This article belongs to the Section Medical Imaging)
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Abstract

Background: Diagnostic performance of positron emission tomography using white blood cells labeled with fluorine-18-fluorodeoxyglucose (18F-FDG-WBC PET or PET/CT) in patients with suspicious infectious diseases has been evaluated in several studies; however, there is no consensus about the diagnostic accuracy of this method. Therefore, a systematic review and meta-analysis was carried out on this topic. Methods: A comprehensive computer literature search screening PubMed/MEDLINE, Embase and Cochrane library databases through March 2019 was performed. Pooled sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR−), and diagnostic odds ratio (DOR) of 18F-FDG-WBC PET or PET/CT in patients with infectious diseases were calculated. Results: Eight studies on the use of 18F-FDG-WBC PET or PET/CT in suspicious infectious diseases were discussed in the systematic review. The meta-analysis of seven studies (236 patients) provided these pooled results on a per patient-based analysis: sensitivity was 86.3% [95% confidence interval (95%CI) 75–92.9%], specificity 92% (95%CI 79.8–97.1%), LR+ 6.6 (95%CI: 3.1–14.1), LR− 0.2 (95%CI: 0.12–0.33), DOR 43.5 (95%CI: 12.2–155). A statistically significant heterogeneity was not detected. Conclusions: Despite limited literature data, 18F-FDG-WBC PET or PET/CT demonstrated a good diagnostic accuracy for the diagnosis of infectious diseases; nevertheless, larger studies are needed. View Full-Text
Keywords: PET; infection; 18F-FDG; leukocytes; white blood cells; meta-analysis PET; infection; 18F-FDG; leukocytes; white blood cells; meta-analysis
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Meyer, M.; Testart, N.; Jreige, M.; Kamani, C.; Moshebah, M.; Muoio, B.; Nicod-Lalonde, M.; Schaefer, N.; Giovanella, L.; Prior, J.O.; Treglia, G. Diagnostic Performance of PET or PET/CT Using 18F-FDG Labeled White Blood Cells in Infectious Diseases: A Systematic Review and a Bivariate Meta-Analysis. Diagnostics 2019, 9, 60.

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