Comparing the diagnostic performance of [18F]FDG PET/CT and [18F]FDG PET/MRI for detecting cardiac sarcoidosis: A meta-analysis

Purpose: This meta-analysis aimed to evaluate the comparative diagnostic efficacy of [18F]FDG PET/CT and [18F] FDG PET/MRI in detecting cardiac sarcoidosis. Methods: An extensive search was conducted in the PubMed and Embase databases to identify available publications up to November 2023. Studies were included if they evaluated the diagnostic efficacy of [18F]FDG PET/ CT and [18F]FDG PET/MRI in patients with cardiac sarcoidosis. Sensitivity and specificity were evaluated using the DerSimonian and Laird method, with subsequent transformation via the Freeman-Tukey double inverse sine transformation. Publication bias was assessed using funnel plots and Egger's test. Results: 16 articles involving 1361 patients were included in the meta-analysis. The overall sensitivity of [18F] FDG PET/CT in detecting cardiac sarcoidosis was 0.77(95%CI: 0.62-0.89), while the overall sensitivity of [18F] FDG PET/MRI was 0.94(95%CI: 0.84-1.00). The result indicated that [18F]FDG PET/MRI appears to a higher sensitivity in comparison to [18F]FDG PET/CT(P = 0.02). In contrast, the overall specificity of [18F]FDG PET/CT in detecting cardiac sarcoidosis was 0.90(95%CI: 0.85-0.94), while the overall specificity of [18F]FDG PET/MRI was 0.79(95%CI: 0.53-0.96), with no significant difference in specificity (P = 0.32). Conclusions: Our meta-analysis indicates that [18F]FDG PET/MRI demonstrates superior sensitivity and comparable specificity to [18F]FDG PET/CT in detecting cardiac sarcoidosis. However, the small number of PET/MRI studies limited the evidence of current results. To validate these results, larger, prospective studies employing a head-to-head design are needed.