Diagnostic performances of F-18 FDG PET or PET/CT for detection of post-transplant lymphoproliferative disorder: a systematic review and meta-analysis.

Abstract

The purpose of the current study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) PET or PET/computed tomography (PET/CT) for detection of post-transplant lymphoproliferative disorder (PTLD) through a systematic review and meta-analysis. The PubMed and EMBASE database, from the earliest available date of indexing through 30 November 2019, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT for the diagnosis of PTLD. Across seven results of five studies (1276 patients), the pooled sensitivity for F-18 FDG PET or PET/CT was 0.90 [95% confidence interval (CI) 0.85-0.93] without heterogeneity (I = 23.3, 95% CI 0.0-85.7, P = 0.25) and a pooled specificity of 0.90 (95% CI 0.86-0.93) without heterogeneity (I = 0.0, 95% CI 0.0-100.0, P = 0.82). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 9.4 (95% CI 6.5-13.7) and negative likelihood ratio (LR-) of 0.11 (95% CI 0.08-0.17). The pooled diagnostic odds ratio was 83 (95% CI 46-149). The hierarchical summary receiver operating characteristic shows the areas under the curve was 0.96 (95% CI 0.94-0.97). The current meta-analysis showed the high sensitivity and specificity of F-18 FDG PET or PET/CT for the detection of PTLD. At present, the literature regarding the use of F-18 FDG PET or PET/CT for the detection of PTLD remains limited; thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of F-18 FDG PET or PET/CT for the diagnosis of PTLD.