Scholarlink

Background <p>2-deoxy-2-[18F]-fluoro-D-glucose ([<sup>18</sup>F]FDG) positron emission tomography/computed tomography (PET/CT) is a hybrid imaging tool increasingly recognized for its effectiveness in evaluating inflammatory and infectious diseases. An emerging application of [<sup>18</sup>F]FDG PET/CT is the detection of infectious and inflammatory foci in critically ill patients within the intensive care unit (ICU). We performed a systematic review and a diagnostic accuracy meta-analysis to assess the value of [<sup>18</sup>F]FDG PET/CT in this setting.</p> Methods <p>A comprehensive literature search was conducted across PubMed/MEDLINE, Embase, and the Cochrane Library databases, covering studies published up to May 2025. Pooled estimates of sensitivity, specificity, positive and negative likelihood ratios (LR + and LR-), and diagnostic odds ratios (DOR) along with their 95% confidence intervals (95% CI), were calculated. In addition, assessment of publication bias and statistical heterogeneity was conducted.</p> Results <p>Eight studies (<i>n</i> = 228 patients) were included in the systematic review with seven studies (<i>n</i> = 181 patients) eligible for the meta-analysis. Most contributions of [<sup>18</sup>F]FDG PET/CT to patient management involved guiding interventional procedures and adjustments to medical therapy such as antimicrobial and corticosteroid treatment. Adverse events related to patient transport or PET/CT scan were not reported in most studies, with exception of one. In terms of diagnostic performance for identifying infectious and inflammatory foci in critically ill patients, the pooled sensitivity, specificity, DOR, LR + and LR − were 91% (95%CI: 80–96), 78% (95%CI: 64–87), 35 (95%CI: 10–121), 4 (95%CI: 2.3–7.1) and 0.12 (0.05–0.28), respectively. No significant statistical heterogeneity or publication bias was detected.</p> Conclusion <p>[<sup>18</sup>F]FDG PET/CT appears to be a reliable imaging tool for detecting infectious and inflammatory foci in critically ill patients. Its findings have a significant impact on clinical decision-making, particularly in guiding interventional procedures and optimizing medical therapy. However, prospective studies to determine the incidence of findings in a unbiased setting and with use of robust reference standards are warranted to further strengthen and validate the diagnostic value of [<sup>18</sup>F]FDG PET/CT.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Diagnostic value of [18F]FDG PET/CT for detection of infectious and inflammatory foci in critically ill patients: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年1月28日

查看全文
  • Giorgio Treglia,
  • Domenico Albano,
  • Xavier Wittebole,
  • Andor W. J. M. Glaudemans,
  • Janesh Pillay,
  • Olivier Gheysens

摘要

Background

2-deoxy-2-[18F]-fluoro-D-glucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) is a hybrid imaging tool increasingly recognized for its effectiveness in evaluating inflammatory and infectious diseases. An emerging application of [18F]FDG PET/CT is the detection of infectious and inflammatory foci in critically ill patients within the intensive care unit (ICU). We performed a systematic review and a diagnostic accuracy meta-analysis to assess the value of [18F]FDG PET/CT in this setting.

Methods

A comprehensive literature search was conducted across PubMed/MEDLINE, Embase, and the Cochrane Library databases, covering studies published up to May 2025. Pooled estimates of sensitivity, specificity, positive and negative likelihood ratios (LR + and LR-), and diagnostic odds ratios (DOR) along with their 95% confidence intervals (95% CI), were calculated. In addition, assessment of publication bias and statistical heterogeneity was conducted.

Results

Eight studies (n = 228 patients) were included in the systematic review with seven studies (n = 181 patients) eligible for the meta-analysis. Most contributions of [18F]FDG PET/CT to patient management involved guiding interventional procedures and adjustments to medical therapy such as antimicrobial and corticosteroid treatment. Adverse events related to patient transport or PET/CT scan were not reported in most studies, with exception of one. In terms of diagnostic performance for identifying infectious and inflammatory foci in critically ill patients, the pooled sensitivity, specificity, DOR, LR + and LR − were 91% (95%CI: 80–96), 78% (95%CI: 64–87), 35 (95%CI: 10–121), 4 (95%CI: 2.3–7.1) and 0.12 (0.05–0.28), respectively. No significant statistical heterogeneity or publication bias was detected.

Conclusion

[18F]FDG PET/CT appears to be a reliable imaging tool for detecting infectious and inflammatory foci in critically ill patients. Its findings have a significant impact on clinical decision-making, particularly in guiding interventional procedures and optimizing medical therapy. However, prospective studies to determine the incidence of findings in a unbiased setting and with use of robust reference standards are warranted to further strengthen and validate the diagnostic value of [18F]FDG PET/CT.