Introduction There has been recent interest in the use of fluorine-18-labelled (18F) tracers in amyloid imaging as they have longer half-lives compared to 11C-labelled Pittsburgh compound-B (11C-PIB). This systematic review and meta-analysis aims to assess the sensitivity and specificity of 18F tracers florbetapir, florbetaben and flutemetamol in diagnosing Alzheimer's disease (AD).

Methods We systematically searched MEDLINE and EMBASE for relevant studies published from January 1980 to March 2014. We pooled the studies comparing imaging findings in AD and normal controls (NC) in a meta-analysis, calculating the pooled weighted sensitivity, specificity and diagnostic odds ratio (OR) using DerSimonian-Laird random effects model.

Results A total of nineteen studies investigating 682 patients with AD, met the inclusion criteria; florbetapir (n=10), florbetaben (n=6), flutemetamol (n=3). Our meta-analysis for florbetapir revealed a pooled weighted sensitivity of 89.6%, specificity of 87.2% and diagnostic OR of 91.7 in differentiating AD from NC; and for florbetaben a pooled weighted sensitivity of 89.3%, specificity of 87.6% and diagnostic OR of 69.9.

Conclusion This meta-analysis demonstrated favourable sensitivity and specificity for 18F tracers in diagnosing AD. Further and larger prospective studies are required to establish an optimal imaging analysis methodology for these tracers for consistency and comparability