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Medicine Oct 2018Spontaneous remission is common in patients with undiagnosed classic fever of unknown origin (FUO). Although identifying reliable predictors of spontaneous remission in... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
Spontaneous remission is common in patients with undiagnosed classic fever of unknown origin (FUO). Although identifying reliable predictors of spontaneous remission in such diagnostically challenging cases could improve their management strategies, few studies have assessed such clinical factors. Recently, studies have reported that F-fluorodeoxyglucose positron emission tomography (F-FDG PET) alone and integrated with computed tomography (PET/CT) were useful in localizing the source of FUO. In this systematic review and meta-analysis, we assessed the association of results of these imaging modalities with spontaneous remission in patients with classic FUO.
METHODS
We searched PubMed and Scopus from inception until June 30, 2018, and studies that evaluated the PET or PET/CT results of ≥10 adult or adolescent patients with classic FUO who were followed up for at least 3 months were included. At least 2 investigators extracted data and rated quality using the QUIPS-2 tool. We used a random-effects meta-analysis to calculate summary risk ratios (RRs) with 95% confidence intervals (CIs).
RESULTS
Nine studies of PET/CT results (418 patients) and 4 studies of standalone PET results (128 patients) were eligible. None explicitly specified the incidence of spontaneous remission as the primary or secondary outcomes of interest. The risk of bias was considered high in all studies because patients received subsequent diagnostic workup based on imaging results. Patients with negative PET/CT results were significantly more likely to present with spontaneous regression than those with positive results (summary RR = 5.6; 95% CI: 3.4-9.2; P < .001; I = 0%). In contrast, no significant association was found between standalone PET results and spontaneous remission. The random-effects study-level meta-regression found that PET/CT results [relative RR (rRR) = 7.4; 95% CI: 2.5-21.3; P = .002], compared with standalone PET results, and publication year (rRR = 1.2 per 1 year; 95% CI: 1.0-1.3; P = .013) were significantly associated with spontaneous remission.
CONCLUSION
Limited data suggest that undiagnosed classic FUO patients with negative PET/CT results had a high likelihood of spontaneous remission after a series of unsuccessful investigations for fever workup. Prospective studies should validate these results.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bias; Fever of Unknown Origin; Fluorodeoxyglucose F18; Humans; Incidence; Middle Aged; Outcome Assessment, Health Care; Positron Emission Tomography Computed Tomography; Prospective Studies; Remission, Spontaneous; Retrospective Studies; Young Adult
PubMed: 30412093
DOI: 10.1097/MD.0000000000012909 -
Hellenic Journal of Nuclear Medicine 2023To conduct a meta-analysis of the diagnostic efficacy of fluorine-18-fluorodeoxyglucose (F-FDG) and gallium-68-labeled fibroblast-activation protein inhibitor (Ga-FAPI)... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To conduct a meta-analysis of the diagnostic efficacy of fluorine-18-fluorodeoxyglucose (F-FDG) and gallium-68-labeled fibroblast-activation protein inhibitor (Ga-FAPI) positron emission tomography/computed tomography (PET/CT) for primary liver cancer based on existing clinical evidence.
MATERIALS AND METHODS
Meta-analysis was carried out according to PRISMA reporting specification. The clinical studies in PubMed/Medline, Embase and the Cochrane Library database were retrieved from the establishment to September 2022. Two researchers independently conducted literature screening and data extraction, evaluated the risk of bias according to QUADAS-2, conducted meta-analysis using Meta Disc 1.4 and Stata15.1 software, and calculated the summarized sensitivity (SEN), specificity (SPE), positive likelihood ratio (+LR), negative likelihood ratio (-LR), and diagnostic odds ratio (DOR). The diagnostic performance of F-FDG PET/CT and Ga-FAPI PET/CT for primary liver cancer was compared using summarized receiver operating characteristic (SROC) curve and area under curve (AUC).
RESULTS
Four original studies on F-FDG PET/CT and Ga-FAPI PET/CT in the diagnosis of primary liver cancer were included, including 159 intrahepatic lesions in 106 patients. Taking lesions as a unit, in four original studies, the pooled results of F-FDG PET/CT diagnosis of primary liver cancer were Sen=0.5 (95% CI:95% CI: 0.41-0.59), Spe=0.87 (95% CI: 0.52-0.98), AUC=0.58 (95% CI:0.53-0.62); The pooled results of Ga-FAPI PET/CT in the diagnosis of primary liver cancer, Sen=0.5 (95% CI: 0.41-0.59), Spe=0.87 (95%CI:0.52-0.98), AUC=0.58 (95% CI:0.53-0.62). Besides, the Sen of Ga-FAPI PET/CT in the diagnosis of primary liver cancer was higher than that of F-FDG PET/CT (Z=2.323, P=0.02), the difference was statistically significant.
CONCLUSION
Gallium-68-FAPI PET/CT is a promising tool. Compared with F-FDG, Ga-FAPI has higher sensitivity to detect more lesions in primary liver cancer and metastatic lesions, and has high performance in the diagnosis of primary liver cancer.
Topics: Humans; Fluorodeoxyglucose F18; Gallium Radioisotopes; Positron Emission Tomography Computed Tomography; Liver Neoplasms; Quinolines
PubMed: 37527048
DOI: 10.1967/s002449912575 -
European Journal of Medical Research Jan 2023To compare the detection rates of [Ga]Ga-FAPI-04 PET MRI/CT vs. [F]-FDG PET MRI/CT in gastric cancer. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To compare the detection rates of [Ga]Ga-FAPI-04 PET MRI/CT vs. [F]-FDG PET MRI/CT in gastric cancer.
METHODS
An extensive librarian-led literature search of PubMed, Embase, Web of Science, the Cochrane Central Library, and ClinicalTrials.gov was performed. The primary outcomes were sensitivity in patient-based evaluations, detection of lymph node metastases, and peritoneal involvement.
RESULTS
Five studies, including 148 participants, were analyzed. [Ga]Ga-FAPI-04 PET MRI/CT has a comparatively high sensitivity in patient-based evaluations compared with [F]-FDG PET MRI/CT (risk difference = 0.16, 95% CI 0.09-0.22, P < 0.00001). The [Ga]Ga-FAPI-04 PET MRI/CT group has a comparatively higher sensitivity in detecting lymph node metastases (RR = 0.15, 95% CI 0.01-0.29, P = 0.04), peritoneal involvement (RR = 0.55, 95% CI 0.38-0.72, P < 0.00001) in gastric cancer than [F]-FDG PET MRI/CT group.
CONCLUSIONS
This systematic review confirmed the advantage of [Ga]Ga-FAPI-04 PET MRI/CT in gastric cancer. [Ga]Ga-FAPI-04 PET MRI/CT was superior to [F]-FDG PET MRI/CT in detecting the primary tumor, lymph node metastases, and peritoneal metastases. More studies are needed for the sensitivity and specificity of [Ga]Ga-FAPI-04 PET MRI/CT in different pathological types of gastric cancer.
Topics: Humans; Fluorodeoxyglucose F18; Gallium Radioisotopes; Stomach Neoplasms; Lymphatic Metastasis; Positron Emission Tomography Computed Tomography; Magnetic Resonance Imaging; Carcinoma
PubMed: 36653862
DOI: 10.1186/s40001-023-00997-9 -
Contrast Media & Molecular Imaging 2017The objective of this meta-analysis is to explore the correlation between the apparent diffusion coefficient (ADC) on diffusion-weighted MR and the standard uptake value... (Meta-Analysis)
Meta-Analysis Review
The objective of this meta-analysis is to explore the correlation between the apparent diffusion coefficient (ADC) on diffusion-weighted MR and the standard uptake value (SUV) of F-FDG on PET/CT in patients with cancer. Databases such as PubMed (MEDLINE included), EMBASE, and Cochrane Database of Systematic Review were searched for relevant original articles that explored the correlation between SUV and ADC in English. After applying Fisher's -to- transformation, correlation coefficient () values were extracted from each study and 95% confidence intervals (CIs) were calculated. Sensitivity and subgroup analyses based on tumor type were performed to investigate the potential heterogeneity. Forty-nine studies were eligible for the meta-analysis, comprising 1927 patients. Pooled for all studies was -0.35 (95% CI: -0.42-0.28) and exhibited a notable heterogeneity ( = 78.4%; < 0.01). In terms of the cancer type subgroup analysis, combined correlation coefficients of ADC/SUV range from -0.12 (lymphoma, = 5) to -0.59 (pancreatic cancer, = 2). We concluded that there is an average negative correlation between ADC and SUV in patients with cancer. Higher correlations were found in the brain tumor, cervix carcinoma, and pancreas cancer. However, a larger, prospective study is warranted to validate these findings in different cancer types.
Topics: Diffusion Magnetic Resonance Imaging; Fluorodeoxyglucose F18; Humans; Lymphoma; Neoplasms; Pancreatic Neoplasms; Positron Emission Tomography Computed Tomography
PubMed: 29097924
DOI: 10.1155/2017/4729547 -
Contrast Media & Molecular Imaging 2021The present systematic literature review and meta-analysis focused on examining the significance of total lesion glycolysis (TLG) and metabolic tumor volume (MTV) in... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The present systematic literature review and meta-analysis focused on examining the significance of total lesion glycolysis (TLG) and metabolic tumor volume (MTV) in predicting the prognosis of stages I/II non-small-cell lung cancer (NSCLC) based on F-FDG PET parameters.
METHODS
Electronic databases, including Cochrane Library, PubMed, and EMBASE, were comprehensively searched for retrieving relevant articles published in the English language. Furthermore, the significance of TLG and MTV in prognosis prediction was analyzed by pooled hazard ratios (HRs).
RESULTS
This work enrolled eight primary studies with 1292 I/II-stage NSCLC cases. The pooled HR (95% confidence interval [CI]) for the ability of increased TLG to predict progression-free survival (PFS) was 2.02 (1.30-2.13) (=0.350), while for increased MTV it was 3.04 (1.92-4.81) (=0.793). In addition, the pooled HR (95% CI) for the ability of increased TLG to predict overall survival (OS) was 2.16 (1.49-3.14) (=0.624). However, higher MTV correlated with OS, and sensitivity analysis showed that the results were not stable. Multivariate and univariate analyses by subgroup analyses stratified by PFS of MTV and OS of TLG exhibited statistically significant differences, without any statistical heterogeneity across various articles.
CONCLUSION
The present work suggests the predictive value of PET/CT among stage I and II NSCLC patients. Our results verified that stage I/II NSCLC cases with increased TLG and MTV had a higher risk of side reactions, and TLG is related to increased mortality risk.
Topics: Carcinoma, Non-Small-Cell Lung; Fluorodeoxyglucose F18; Glycolysis; Humans; Lung Neoplasms; Positron Emission Tomography Computed Tomography; Prognosis; Radiopharmaceuticals; Tumor Burden
PubMed: 34887713
DOI: 10.1155/2021/7528971 -
Medicine Mar 2019Pulmonary carcinoids (PC) are histologically classified into typical carcinoid (TC) and atypical carcinoid (AC). The diagnosis of pulmonary carcinoid and possibly the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Pulmonary carcinoids (PC) are histologically classified into typical carcinoid (TC) and atypical carcinoid (AC). The diagnosis of pulmonary carcinoid and possibly the differentiation between TC and AC could make a significant effect on the treatment planning as well as prognosis. Several studies have explored the utility of Ga-DOTA-Peptide (Ga-labelled [1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid]-peptide) and F-flurodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in the evaluation of primary pulmonary carcinoids. Therefore, we performed a meta-analysis to evaluate the diagnostic accuracy and prediction efficiency of histological subtypes of these two imaging modalities in primary PC.
METHODS
Relevant studies were identified by searching PubMed, Web of Science, and EMBASE published from 2006 to 2016. Two authors extracted characteristics of patients and their lesions using predefined criteria.
RESULTS
Fourteen studies comprising 352 patients were included in this meta-analysis. The pooled sensitivity of Ga-DOTA-Peptide and F-FDG PET/CT in detecting pulmonary carcinoid were 90.0% (95% CI = 82.0-95.0%; P = .07; I = 49.6%) and 71.0% (95% CI = 66.0-76.0%; P < .001; I = 59.3%), respectively. An SUVmax ratio between Ga-DOTA-Peptide and F-FDG higher than the cutoff value of 4.28 was predictive of TC with 89.3% sensitivity and 100% specificity (AUC, 96.4%; 95% CI, 91.1-100%). The ratio of tumor uptake to atelectatic lung uptake was significantly higher for Ga-DOTA-peptide (2.5-91, mean 30.5 ± 28.1) than for F-FDG (0.3-10.3, mean 2.1 ± 2.3) (P < .001).
CONCLUSIONS
Both Ga-DOTA-peptide and F-FDG are highly sensitive in detecting pulmonary carcinoid, while Ga-DOTA-peptide is more sensitive than F-FDG (90.0% vs 71.0%). The SUVmax ratio was an accurate predictor of the histopathologic variety of the carcinoid tumor, and Ga-DOTA-peptide was better than F-FDG in cases with atelectasis.
Topics: Acetates; Carcinoid Tumor; Fluorodeoxyglucose F18; Gallium Radioisotopes; Humans; Lung Neoplasms; Peptides, Cyclic; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals
PubMed: 30855482
DOI: 10.1097/MD.0000000000014769 -
European Journal of Vascular and... Sep 2016Methods are required to identify abdominal aortic aneurysms (AAAs) at increased risk of rupture. Inflammatory characteristics of AAA can be visualised using advanced... (Review)
Review
BACKGROUND
Methods are required to identify abdominal aortic aneurysms (AAAs) at increased risk of rupture. Inflammatory characteristics of AAA can be visualised using advanced imaging techniques and have been proposed as potential predictors of aneurysm progression. The objective of this review was to determine which inflammatory imaging biomarkers are associated with AAA growth and rupture.
METHODS
A systematic review was carried out in accordance with the PRISMA guidelines. The electronic databases of Medline (PubMed), Embase, and the Cochrane Library were searched up to January 1, 2016 for studies to determine the potential association between inflammatory imaging biomarkers and AAA growth or rupture.
RESULTS
Seven studies were included, comprising 202 AAA patients. (18)F-fluoro-deoxy-glucose positron emission tomography ((18)F-FDG PET-CT) was evaluated in six studies. Magnetic resonance imaging with ultrasmall superparamagnetic particles of iron oxide (USPIO-MRI) was evaluated in one study. Two of six (18)F-FDG PET-CT studies reported a significant negative correlation (r=.383, p = .015) or a significant negative association (p = .04). Four of six (18)F-FDG PET-CT studies reported no significant association between (18)F-FDG uptake and AAA growth. The single study investigating USPIO-MRI demonstrated that AAA growth was three times higher in patients with focal USPIO uptake in the AAA wall compared to patients with diffuse or no USPIO uptake in the wall (0.66 vs. 0.24 vs. 0.22 cm/y, p = .020). In the single study relating (18)F-FDG uptake results to AAA rupture, the association was not significant.
CONCLUSIONS
Current evidence shows contradictory associations between (18)F-FDG uptake and AAA growth. Data on the association with rupture are insufficient. Based on the currently available evidence, neither (18)F-FDG PET-CT nor USPIO-MRI can be implemented as growth or rupture prediction tools in daily practice. The heterogeneous results reflect the complex and partially unclear relationship between inflammatory processes and AAA progression.
Topics: Aorta, Abdominal; Aortic Aneurysm, Abdominal; Aortic Rupture; Aortitis; Aortography; Computed Tomography Angiography; Contrast Media; Dextrans; Disease Progression; Fluorodeoxyglucose F18; Humans; Magnetic Resonance Angiography; Magnetite Nanoparticles; Molecular Imaging; Positron Emission Tomography Computed Tomography; Predictive Value of Tests; Radiopharmaceuticals; Reproducibility of Results; Risk Assessment; Risk Factors
PubMed: 27283346
DOI: 10.1016/j.ejvs.2016.05.002 -
Sao Paulo Medical Journal = Revista... 2015Positron emission tomography with [18]F-fluoro-2-deoxyglucose (FDG-PET/CT) has been advocated as the method of choice for lymphoma staging, since it enables whole-body... (Comparative Study)
Comparative Study Meta-Analysis Review
CONTEXT AND OBJECTIVE
Positron emission tomography with [18]F-fluoro-2-deoxyglucose (FDG-PET/CT) has been advocated as the method of choice for lymphoma staging, since it enables whole-body analysis with high sensitivity for detection of affected areas and because it combines capacities for anatomical and functional assessment. With technological advances, magnetic resonance imaging (MRI) has emerged as an alternative to FDG-PET/CT. This systematic review with meta-analysis aimed to compare whole-body diffusion-weighted MRI (WB-MRI) with FDG-PET/CT for lymphoma staging.
DESIGN AND SETTING
Systematic review on diagnostic test accuracy studies conducted at a public university.
METHODS
The Medline, Scopus, Embase and Lilacs databases were searched for studies published up to September 2013 that compared WB-MRI and FDG-PET/CT for lymphoma staging. The reference lists of included studies were checked for any relevant additional citations.
RESULTS
Six studies that evaluated the initial lymphoma staging in 116 patients were included. WB-MRI and FDG-PET/CT agreed in 90.5% of the cases (κ = 0.871; P < 0.0001). In most of the studies, when there was disagreement between the methods, WB-MRI overstaged in relation to FDG-PET/CT. The sensitivity of WB-MRI and FDG-PET/CT, in comparison with the clinical-radiological standard, ranged from 59 to 100% and from 63 to 100% respectively.
CONCLUSION
WB-MRI is a highly sensitive method for initial lymphoma staging. It has excellent agreement with FDG-PET/CT and is a great alternative for managing lymphoma patients, without using ionizing radiation or an intravenous contrast agent.
Topics: Confidence Intervals; Diagnostic Tests, Routine; Diffusion Magnetic Resonance Imaging; Hodgkin Disease; Humans; Lymphoma; Lymphoma, Non-Hodgkin; Neoplasm Staging; Positron-Emission Tomography; Sensitivity and Specificity; Tomography, X-Ray Computed; Whole Body Imaging
PubMed: 25789779
DOI: 10.1590/1516-3180.2014.8312810 -
PloS One 2019A comprehensive systematic review of the literature was conducted on parameters from 18 F-FDG PET and a meta-analysis of the prognostic value of the maximal standard... (Meta-Analysis)
Meta-Analysis
Prognostic value of maximum standard uptake value, metabolic tumor volume, and total lesion glycolysis of positron emission tomography/computed tomography in patients with breast cancer: A systematic review and meta-analysis.
PURPOSE
A comprehensive systematic review of the literature was conducted on parameters from 18 F-FDG PET and a meta-analysis of the prognostic value of the maximal standard uptake value (SUVmax), metabolic tumor volume (MTV) and total lesional glycolysis (TLG) in patients with breast cancer (BC).
PATIENTS AND METHODS
Relevant English articles from PubMed, EMBASE, and the Cochrane Library were retrieved. Pooled hazard ratios (HRs) were used to assess the prognostic value of SUVmax, MTV, and TLG.
RESULTS
A total of 20 primary studies with 3115 patients with BC were included. The combined HRs (95% confidence interval [CI] of higher SUVmax and higher TLG for event-free survival (EFS) were 1.53 (95% CI, 1.25-1.89, P = 0.0006) and 5.94 (95% CI, 2.57-13.71, P = 0.97), respectively. Regarding the overall survival (OS), the combined HRs were 1.22 (95%CI, 1.02-1.45, P = 0.0006) with higher SUVmax, and 2.91(95% CI, 1.75-4.85, P = 0.44) with higher MTV. Higher MTV showed no correlation with EFS [1.31(95% CI, 0.65-2.65, P = 0.18)] and similarly higher TLG showed no correlation with OS [1.20(95% CI, 0.65-2.23, P = 0.45)]. Subgroup analysis showed that SUVmax, with a median value of 5.55 was considered as a significant risk factor for both EFS and OS in BC patients.
CONCLUSION
Despite clinically heterogeneous BC patients and adoption of various methods between studies, the present meta-analysis results confirmed that patients with high SUVmax are at high risk of adverse events or death in BC patients, high MTV predicted a high risk of death and high TLG predicted a high risk of adverse events.
Topics: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Energy Metabolism; Female; Fluorodeoxyglucose F18; Glycolysis; Humans; Middle Aged; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Prognosis; Tumor Burden
PubMed: 31826010
DOI: 10.1371/journal.pone.0225959 -
Contrast Media & Molecular Imaging 2018Our purpose was to provide data regarding relationships between F-FDG PET and histopathological parameters in lung cancer. (Meta-Analysis)
Meta-Analysis
Standardized Uptake Values Derived from F-FDG PET May Predict Lung Cancer Microvessel Density and Expression of KI 67, VEGF, and HIF-1 but Not Expression of Cyclin D1, PCNA, EGFR, PD L1, and p53.
BACKGROUND
Our purpose was to provide data regarding relationships between F-FDG PET and histopathological parameters in lung cancer.
METHODS
MEDLINE library was screened for associations between PET parameters and histopathological features in lung cancer up to December 2017. Only papers containing correlation coefficients between PET parameters and histopathological findings were acquired for the analysis. Overall, 40 publications were identified.
RESULTS
Associations between SUV and KI 67 were reported in 23 studies (1362 patients). The pooled correlation coefficient was 0.44. In 2 studies (180 patients), relationships between SUV and expression of cyclin D1 were analyzed (pooled correlation coefficient = 0.05). Correlation between SUV and HIF-1 was investigated in 3 studies (288 patients), and the pooled correlation coefficient was 0.42. In 5 studies (310 patients), associations between SUV and MVD were investigated (pooled correlation coefficient = 0.54). In 6 studies (305 patients), relationships between SUV and p53 were analyzed (pooled correlation coefficient = 0.30). In 6 studies (415 patients), associations between SUV and VEGF expression were investigated (pooled correlation coefficient = 0.44). In 5 studies (202 patients), associations between SUV and PCNA were investigated (pooled correlation coefficient = 0.32). In 3 studies (718 patients), associations between SUV and expression of PD L1 were analyzed (pooled correlation coefficient = 0.36). Finally, in 5 studies (409 patients), associations between SUV and EGFR were investigated (pooled correlation coefficient = 0.38).
CONCLUSION
SUV may predict microvessel density and expression of VEGF, KI 67, and HIF-1 in lung cancer.
Topics: B7-H1 Antigen; Cyclin D1; Fluorodeoxyglucose F18; Gene Expression Regulation, Neoplastic; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Ki-67 Antigen; Lung Neoplasms; Microvessels; Positron-Emission Tomography; Proliferating Cell Nuclear Antigen; Tumor Suppressor Protein p53
PubMed: 29983647
DOI: 10.1155/2018/9257929