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Diagnostic performance of F-18 fluorodeoxyglucose PET/computed tomography for diagnosis of polymyalgia rheumatica: a meta-analysis

Objective The purpose of the current study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) PET/computed tomography (CT) for diagnosis of polymyalgia rheumatic (PMR) through a meta-analysis. Methods The PubMed, Cochrane and EMBASE database, from the earliest available date of indexing up to 29 February 2020, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for diagnosis of PMR. Results Across the 11 results of seven studies selected for analysis (684 patients), the pooled sensitivity for F-18 FDG PET/CT was 0.76 [95% confidence interval (CI), 0.67–0.83] with heterogeneity (I2 = 74.9, P < 0.001) and a pooled specificity of 0.87 (95% CI, 0.82–0.91) with heterogeneity (I2 = 61.2, P < 0.001). Likelihood ratio syntheses gave an overall positive likelihood ratio of 5.7 (95% CI, 4.3–7.7) and negative likelihood ratio of 0.28 (95% CI, 0.2–0.38). The pooled diagnostic odds ratio was 21 (95% CI, 13–32). The hierarchical summary receiver operating characteristic curve indicated the areas under the curve as 0.93 (95% CI, 0.90–0.95). Conclusion The current meta-analysis showed a moderate sensitivity and specificity of F-18 FDG PET/CT for the diagnosis of PMR. Currently, the literature on the use of F-18 PET/CT for the diagnosis of PMR is limited. Thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of F-18 FDG PET/CT for the detection of PMR.