What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Myocardial Inflammation (n=1900). Intervention: Cardiac MRI (CMR) vs. FDG-PET. Primary outcome: Pooled sensitivity (95% CI 0.85-0.92).

What does this research mean for the field?

Cardiac MRI demonstrates a pooled sensitivity of 0.89 and specificity of 0.87 for detecting myocardial inflammation, whereas FDG-PET has higher sensitivity (0.93) but lower specificity (0.71). Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

December 31, 2025CureusOpen Access

Comparative Diagnostic Performance of Cardiac MRI and FDG-PET in Myocardial Inflammation: A Systematic Review and Meta-Analysis

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Key result

Cardiac MRI provides higher specificity but slightly lower sensitivity than FDG-PET for detecting myocardial inflammation.

95% CI 0.85-0.92
n=1,900

Why the study?

Endomyocardial biopsy has significant limitations, making noninvasive imaging central to diagnosing cardiac inflammation, but a comparison of the diagnostic performance of CMR and FDG-PET was needed.

Does CMR or FDG-PET provide better diagnostic performance for detecting myocardial inflammation in adults?

Comparison

CMR vs FDG-PET

Design

Systematic review and meta-analysis

Authors

BABareq Sabeeh Al-LamiHawler Medical University MYMustapha El YamanConquest Hospital ASAbdulrahman O SaeedHawler Medical University

Discussion

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Implication

CMR may be prioritized initially for its specificity; leaves open optimal FDG-PET integration pending prospective trials.

Study Design

Type

Meta-Analysis (n=1,900)

Structured PICO

Does CMR or FDG-PET provide better diagnostic performance for detecting myocardial inflammation in adults?

Population

Adults with suspected or confirmed cardiac inflammation (including myocarditis and cardiac sarcoidosis) across 26 studies (17 CMR, 9 FDG-PET).

Intervention

Cardiac magnetic resonance (CMR) and fluorodeoxyglucose F-18 positron emission tomography (18F-FDG-PET)

Comparator

Comparative diagnostic performance between the two imaging modalities

Outcome

Diagnostic performance (sensitivity and specificity)surrogate

Main Result

Absolute Event Rate: 0.89% vs 0.93%

CMR provides high, reliable specificity for myocardial inflammation, while FDG-PET offers greater sensitivity, supporting a stepwise diagnostic approach starting with CMR.

Limitations

Heterogeneity in the source literature, including differences in study design, patient selection, imaging protocols, and reference standards
Many studies were single-center or retrospective with highly selected populations, limiting generalizability
Some studies relied on composite clinical criteria rather than histologic confirmation
Endomyocardial biopsy remains susceptible to sampling error in patchy disease
Publication bias cannot be excluded
Absence of patient-level data restricted detailed subgroup analyses

Cite This Study

Al-Lami et al. (2025) conducted a meta-analysis in Myocardial Inflammation (n=1,900). Cardiac MRI (CMR) vs. FDG-PET was evaluated on Pooled sensitivity (95% CI 0.85-0.92). Cardiac MRI demonstrated a pooled sensitivity of 0.89 and specificity of 0.87 for detecting myocardial inflammation, whereas FDG-PET showed a higher sensitivity of 0.93 but lower specificity of 0.71.

synapsesocial.com/papers/6a0ba9064f6759c6fca25487 https://doi.org/10.7759/cureus.100482

Topics

Myocarditis

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Comparative Diagnostic Performance of Cardiac MRI and FDG-PET in Myocardial Inflammation: A Systematic Review and Meta-Analysis

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Comparative Diagnostic Performance of Cardiac MRI and FDG-PET in Myocardial Inflammation: A Systematic Review and Meta-Analysis

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

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