Performance of [ 18 F]FDG PET/CT in Diagnosing Cyst Infections in Patients with Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and a Bivariate Meta-Analysis.

Background: Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ([ ¹⁸ F]FDG PET/CT) has been suggested as a useful imaging method for diagnosing cyst infections in patients with autosomal dominant polycystic kidney disease (ADPKD). The aim of this article is to provide evidence-based data in this setting.
Methods: A systematic literature review (exploring several bibliographic databases) and a bivariate meta-analysis were carried out to calculate the pooled diagnostic performance of [ ¹⁸ F]FDG PET/CT in diagnosing probable cyst infection in ADPKD.
Results: Ten studies (282 PET/CT scans and 249 patients) were included in the analysis. The pooled sensitivity and specificity of [ ¹⁸ F]FDG PET/CT in this setting were 84.6% (95% confidence interval: 75.4-90.7) and 94.9% (95% confidence interval: 72.6-99.2), respectively, without statistical heterogeneity or significant publication bias. [ ¹⁸ F]FDG PET/CT significantly changed patient management in more than half of ADPKD patients with suspected cyst infection.
Conclusions: [ ¹⁸ F]FDG PET/CT has high performance in diagnosing probable cyst infections in ADPKD patients with an impact on management in the majority of patients. Although more studies are warranted, the provided evidence-based data are an important step towards the integration of [ ¹⁸ F]FDG PET/CT in clinical and diagnostic guidelines on probable cyst infection in ADPKD patients.