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Comparison of cardiac magnetic resonance imaging and fluorodeoxyglucose positron emission tomography in the assessment of cardiac sarcoidosis: Meta-analysis and systematic review

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Journal of Nuclear Cardiology Aims and scope

Abstract

Aim

Fluorine-18 fluorodeoxyglucose-positron emission tomography (FDG-PET) and cardiac magnetic resonance (CMR) are frequently used advanced cardiac imaging to diagnose cardiac sarcoidosis (CS). We conducted a meta-analysis and systematic review to compare diagnostic parameters of FDG-PET and CMR in the diagnosis of cardiac sarcoidosis (CS).

Methods

We searched PubMed, EMBASE, and Scopus databases from their inception to 9/30/2021 with search terms “cardiac sarcoidosis” AND “cardiac magnetic resonance imaging” AND “positronemission tomography”. We extracted patient characteristics, results of the FDG-PET and CMR, and adverse outcomes from the included studies. Adverse outcomes served as a reference standard for the evaluation of FDG-PET and CMR.

Results

We included 4 studies in the meta-analysis which provided adverse outcomes and all patients underwent FDG-PET and CMR. There were 237 patients, 60.3% male, and ages ranged from 50-53 years. There were 45 events in 237 patients from four studies included in the meta-analyses. The pooled sensitivity (95% confidence interval-CI) and specificity (CI) of CMR in predicting an adverse event were 0.94 (0.79-0.98) and 0.49 (0.40-0.59), respectively. The pooled sensitivity (CI) and specificity (CI) of FDG-PET in predicting an adverse event were 0.51 (0.26-0.75) and 0.60 (0.35-0.81), respectively.

Conclusion

CMR was more sensitive but less specific than FDG-PET in predicting adverse events; however, the study population and definition of a positive test need to be considered while interpreting the results.

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Abbreviations

AVB:

Atrioventricular block

CAD:

Coronary artery disease

CMR:

Cardiac magnetic resonance

CS:

Cardiac sarcoidosis

EMB:

Endomyocardial biopsy

FDG-PET:

Fluorine-18 fluorodeoxyglucose-positron emission tomography

HRS:

Heart Rhythm Society

HSROC:

Hierarchical summary receiver operating characteristic

LVEF:

Left ventricular ejection fraction

VT:

Ventricular tachycardia

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Acknowledgements

Riley J. Samuelson, MA, University of Iowa Libraries

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Authors and Affiliations

  1. Division of General Internal Medicine, University of Iowa Department of Internal Medicine, Iowa City, USA

    Mehul Adhaduk MD, MS, Bishow Paudel MD & Muhammad Umar Khalid MBBS

  2. Division of Cardiovascular Medicine, University of Iowa Department of Internal Medicine, Iowa City, USA

    Mahi Ashwath MD, MBA, Shareef Mansour MBBS & Kan Liu MD, PhD

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  1. Mehul Adhaduk MD, MS
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Correspondence to Mehul Adhaduk MD, MS.

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Adhaduk, M., Paudel, B., Khalid, M.U. et al. Comparison of cardiac magnetic resonance imaging and fluorodeoxyglucose positron emission tomography in the assessment of cardiac sarcoidosis: Meta-analysis and systematic review. J. Nucl. Cardiol. 30, 1574–1587 (2023). https://doi.org/10.1007/s12350-022-03129-8

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