Diagnostic performance of FDG PET or PET/CT in prosthetic infection after arthroplasty: a meta-analysis.
OBJECTIVE
The purpose of this study was to systematically review and perform a meta-analysis of published data regarding the diagnostic performance of positron emission tomography (PET) or PET/computed tomography (PET/CT) in prosthetic infection after arthroplasty.


METHODS
A comprehensive computer literature search of studies published through May 31, 2012 regarding PET or PET/CT in patients suspicious of prosthetic infection was performed in PubMed/MEDLINE, Embase and Scopus databases. Pooled sensitivity and specificity of PET or PET/CT in patients suspicious of prosthetic infection on a per prosthesis-based analysis were calculated. The area under the receiver-operating characteristic (ROC) curve was calculated to measure the accuracy of PET or PET/CT in patients with suspicious of prosthetic infection.


RESULTS
Fourteen studies comprising 838 prosthesis with suspicious of prosthetic infection after arthroplasty were included in this meta-analysis. The pooled sensitivity of PET or PET/CT in detecting prosthetic infection was 86% (95% confidence interval [CI] 82-90%) on a per prosthesis-based analysis. The pooled specificity of PET or PET/CT in detecting prosthetic infection was 86% (95% CI 83-89%) on a per prosthesis-based analysis. The area under the ROC curve was 0.93 on a per prosthesis-based analysis.


CONCLUSIONS
In patients suspicious of prosthetic infection, FDG PET or PET/CT demonstrated high sensitivity and specificity. FDG PET or PET/CT are accurate methods in this setting. Nevertheless, possible sources of false positive results and influcing factors should kept in mind.
Nuclear Medicine Department Beijing Friendship Hospital of Capital Medical University Beijing, China - nmyangjigang@gmail.com.
H
H
Jin
L
L
Yuan
C
C
Li
Y
Y
Kan
R
R
Hao
J
J
Yang
D000465:Algorithms; D001178:Arthroplasty / Q000009:adverse effects*; D005189:False Positive Reactions; D019788:Fluorodeoxyglucose F18; D006801:Humans; D064847:Multimodal Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D011183:Postoperative Complications; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging*; D012372:ROC Curve; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18