Diagnostic performance of Fluorine-18-Fluorodeoxy-glucose positron emission tomography in patients with chronic inflammatory bowel disease: A systematic review and a meta-analysis

Objective: To systematically review and meta-analyze published data about the diagnostic performance of Fluorine-18-Fluorodeoxyglucose (F-18-FDG) positron emission tomography (PET) and PET/computed tomography (PET/CT) in patients with chronic inflammatory bowel disease (IBD). Methods: A comprehensive computer literature search of studies published through May 2012 regarding F-18-FDG-PET and PET/CT in patients with IBD was performed. All retrieved studies were reviewed and qualitatively analyzed. Pooled sensitivity, specificity, positive and negative likelihood ratio (LR+ and LR-) and diagnostic odd ratio (DOR) of F-18-FDG PET and PET/CT in patients with IBD on a per segment-based analysis were calculated. The area under the ROC curve was calculated to measure the accuracy of F-18-FDG PET and PET/CT in patients with IBD. Results: Nineteen studies comprising 454 patients with suspected IBD were included in the qualitative analysis (systematic review) and discussed. The quantitative analysis (meta-analysis) of seven selected studies (including 219 patients with IBD) provided the following results on a per segment-based analysis: sensitivity was 85% [95% confidence interval (95%CI) 81-88%], specificity 87% (95%CI 84-90%), LR+ 6.19 (95%CI: 2.86-13.41), LR- 0.19 (95%CI: 0.10-0.34), and DOR 44.35 (95%CI: 11.77-167.07). The area under the ROC curve was 0.933. Conclusions: In patients with suspected IBD F-18-FDG PET and PET/CT demonstrated good sensitivity and specificity, being accurate methods in this setting. Nevertheless, the literature focusing on the use of PET and PET/CT in IBD remains still limited; thus, further large multicenter studies will be necessary to substantiate the diagnostic accuracy of these methods in patients with IBD. (C) 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.