• Seong-Jang Kim, Kyoungjune Pak, Keunyoung Kim, and Jung Sub Lee.
• Department of Nuclear Medicine, BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
• Spine. 2019 Apr 1; 44 (7): E414-E422.

Study DesignA meta-analysis.ObjectiveThe aim of this study was to compare the diagnostic accuracies of F-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) and magnetic resonance imaging (MRI) for the detection of spondylodiscitis through a meta-analysis.Summary Of Background DataThere is no meta-analysis study that compares the diagnostic accuracies of F-18 FDG PET and MRI for the detection of spondylodiscitis.MethodsThe MEDLINE and EMBASE databases were searched from the earliest available date of indexing to January 10, 2018 for studies comparing the diagnostic performance F-18 FDG PET with that of MRI for the detection of spondylodiscitis. We determined the sensitivities and specificities across studies, calculated the positive and negative likelihood ratios (LR+ and LR-), and constructed the summary receiver operating characteristic curves.ResultsIn the seven studies (212 patients) selected, the pooled sensitivity and specificity of F-18 FDG PET were 0.95 (95% confidence interval [CI]: 0.87-0.98) and 0.88 (95% CI: 0.73-0.95), respectively. The LR syntheses showed an overall LR+ of 7.6 (95% CI: 3.4-17.2) and LR- of 0.05 (95% CI: 0.02-0.14). The pooled diagnostic odds ratio was 141 (95% CI: 44-444). The pooled sensitivity and specificity of MRI were 0.85 (95% CI: 0.65-0.95) and 0.66 (95% CI: 0.48-0.80), respectively. The LR syntheses showed an overall LR+ of 2.5 (95% CI: 1.5-4.2) and LR- of 0.22 (95% CI: 0.08-0.60). The pooled diagnostic odds ratio was 11 (95% CI: 3-42). In the meta-regression analysis, no variable was identified as the source of the study heterogeneity.ConclusionThe current meta-analysis shows that F-18 FDG PET has better diagnostic accuracy than MRI for the detection of spondylodiscitis. Further large multicenter studies would be necessary to substantiate the diagnostic accuracies of F-18 FDG PET and MRI for spondylodiscitis.Level Of Evidence2.

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