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Value of SPECT/CT in the diagnosis of avascular necrosis of the head of femur: A meta-analysis
Institution:1. Department of Nuclear Medicine, Gujranwala Institute of Nuclear Medicine & Radiotherapy (GINUM), Gujranwala, Pakistan;2. School of Dentistry & Medical Sciences (SDHS), Charles Sturt University, Wagga Wagga, NSW, 2670, Australia;1. Inspeção Geral da Agricultura, do Mar, do Ambiente, e do Ordenamento do Territorio (IGAMOT), Seção Radiações Ionizantes, Rua de O Seculo, N.51, 1200-433, Lisbon, Portugal;2. Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Campus Tecnológico e Nuclear, Estrada Nacional 10, km 139,7, 2695-066, Bobadela LRS, Portugal;3. Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal;4. Agência Portuguesa do Ambiente, Departamento de Emergências e Proteção Radiológica, Divisão de Autorização e Segurança Nuclear, Rua da Murgueira 9 – Zambujal – Alfragide, 2610-124, Amadora, Portugal;1. University Hospital Southampton NHS Foundation Trust, United Kingdom;2. School of Health and Social Well-Being, University of the West of England (UWE) Bristol, UK
Abstract:IntroductionTo evaluate the diagnostic value of single photon emission computed tomography/computed tomography (SPECT/CT) in patients with avascular necrosis (AVN) of the femoral head.MethodsA search of the databases PubMed, ScienceDirect, and Google Scholar was undertaken using targeted index word. Studies satisfying inclusions and exclusions criteria were identified and additional related literature sources were considered. Analysis included pooled sensitivity and specificity, odds ratio (OR), and receiver operating characteristic (ROC) analysis.ResultsSeven studies were identified that specifically related to the diagnostic accuracy of SPECT/CT in the detection or characterisation of AVN of the femoral head. These were included in the meta-analysis. The pooled sensitivity and specificity were 94% (95% confidence interval of 87–97%) and 75% (95% confidence interval of 68–81%) respectively, the OR was 44.5 (with a 95% confidence interval of 18.2–108.6), and the area under the SROC was 93.73% (with a 95% confidence interval of 89.2%–98.3%).ConclusionThis meta-analysis provides strong evidence of the high diagnostic efficacy of SPECT/CT in the evaluation of AVN of the femoral head.Implications for practiceIn the absence of or contraindication to MRI, SPECT/CT is able to provide a suitable alternative for diagnosis of AVN of the head of femur.
Keywords:Avascular necrosis  AVN  Osteonecrosis  Head of the femur  SPECT/CT  Hybrid imaging  AVN"}  {"#name":"keyword"  "$":{"id":"pc_eyTATtfU67"}  "$$":[{"#name":"text"  "_":"Avascular Necrosis  PRISMA"}  {"#name":"keyword"  "$":{"id":"pc_LQ9bCE3l7K"}  "$$":[{"#name":"text"  "_":"Preferred Reporting Items for Systematic Reviews and Meta-Analyses  QUADAS"}  {"#name":"keyword"  "$":{"id":"pc_vMbAmZReEe"}  "$$":[{"#name":"text"  "_":"Quality Assessment of Diagnostic Accuracy Studies
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