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Pediatric Blood & Cancer Mar 2022The aim of this study was to evaluate the diagnostic accuracy of -fluorodeoxyglucose-positron emission tomography ( F-FDG PET) and PET/computed tomography (PET/CT) in... (Meta-Analysis)
Meta-Analysis
PURPOSE
The aim of this study was to evaluate the diagnostic accuracy of -fluorodeoxyglucose-positron emission tomography ( F-FDG PET) and PET/computed tomography (PET/CT) in imaging primary and metastatic lesions in Ewing sarcoma (ES).
METHODS
PubMed, Cochrane, Scopus, and Web of Science were searched for relevant studies. Data concerning F-FDG PET/CT diagnostic accuracy were extracted and then analyzed using Open Meta-analyst software. Reported diagnostic accuracy outcomes included sensitivity, specificity, negative likelihood ratio (NLR), positive likelihood ratio (PLR), and diagnostic odds ratio.
RESULTS
Thirty-one studies with a total of 735 patients were included in this meta-analysis. The sensitivity and specificity of F-FDG PET/CT were: 92.6% and 74.1% for total ES lesions, 96.7% and 68.3% for ES primary lesions, 76.1% and 92.4% for lung metastasis, 83.9% and 93.2% for bone metastasis, and 89.9% and 92.6% for ES recurrence, respectively.
CONCLUSION
F-FDG PET/CT is sensitive and accurate in diagnosing, staging, and detecting the recurrence of ES compared with non-PET imaging. It has high accuracy for diagnosing recurrence of ES in bone metastases; however, CT remains a superior diagnostic method for detecting lung metastasis.
Topics: Bone Neoplasms; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Neuroectodermal Tumors, Primitive, Peripheral; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiopharmaceuticals; Sarcoma, Ewing; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 34709700
DOI: 10.1002/pbc.29415 -
European Journal of Nuclear Medicine... Dec 2021Fibroblast activation protein-α (FAPα) is overexpressed on cancer-associated fibroblasts in approximately 90% of epithelial neoplasms, representing an appealing target... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Fibroblast activation protein-α (FAPα) is overexpressed on cancer-associated fibroblasts in approximately 90% of epithelial neoplasms, representing an appealing target for therapeutic and molecular imaging applications. [ Ga]Ga-labelled radiopharmaceuticals-FAP-inhibitors (FAPI)-have been developed for PET. We systematically reviewed and meta-analysed published literature to provide an overview of its clinical role.
MATERIALS AND METHODS
The search, limited to January 1st, 2018-March 31st, 2021, was performed on MedLine and Embase databases using all the possible combinations of terms "FAP", "FAPI", "PET/CT", "positron emission tomography", "fibroblast", "cancer-associated fibroblasts", "CAF", "molecular imaging", and "fibroblast imaging". Study quality was assessed using the QUADAS-2 criteria. Patient-based and lesion-based pooled sensitivities/specificities of FAPI PET were computed using a random-effects model directly from the STATA "metaprop" command. Between-study statistical heterogeneity was tested (I-statistics).
RESULTS
Twenty-three studies were selected for systematic review. Investigations on staging or restaging head and neck cancer (n = 2, 29 patients), abdominal malignancies (n = 6, 171 patients), various cancers (n = 2, 143 patients), and radiation treatment planning (n = 4, 56 patients) were included in the meta-analysis. On patient-based analysis, pooled sensitivity was 0.99 (95% CI 0.97-1.00) with negligible heterogeneity; pooled specificity was 0.87 (95% CI 0.62-1.00), with negligible heterogeneity. On lesion-based analysis, sensitivity and specificity had high heterogeneity (I = 88.56% and I = 97.20%, respectively). Pooled sensitivity for the primary tumour was 1.00 (95% CI 0.98-1.00) with negligible heterogeneity. Pooled sensitivity/specificity of nodal metastases had high heterogeneity (I = 89.18% and I = 95.74%, respectively). Pooled sensitivity in distant metastases was good (0.93 with 95% CI 0.88-0.97) with negligible heterogeneity.
CONCLUSIONS
FAPI-PET appears promising, especially in imaging cancers unsuitable for [F]FDG imaging, particularly primary lesions and distant metastases. However, high-level evidence is needed to define its role, specifically to identify cancer types, non-oncological diseases, and clinical settings for its applications.
Topics: Endopeptidases; Fluorodeoxyglucose F18; Gelatinases; Head and Neck Neoplasms; Humans; Membrane Proteins; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Serine Endopeptidases
PubMed: 34173007
DOI: 10.1007/s00259-021-05475-0 -
AJR. American Journal of Roentgenology Apr 2022Traditional approaches for evaluating multiple myeloma (MM) treatment response have low sensitivity for residual disease. Recent studies highlight the utility of... (Meta-Analysis)
Meta-Analysis
Traditional approaches for evaluating multiple myeloma (MM) treatment response have low sensitivity for residual disease. Recent studies highlight the utility of whole-body MRI or FDG PET/CT in evaluating treatment response, with increasing emphasis on DWI. This systematic review was conducted to assess the diagnostic accuracy of whole-body MRI and FDG PET/CT for MM treatment response assessment. Studies in which whole-body MRI or FDG PET/CT was used to evaluate MM treatment response were identified through search of the PubMed and EMBASE databases through June 30, 2021. Pooled sensitivity and specificity for detecting response were calculated by bivariate modeling. The diagnostic performances of whole-body MRI and FDG PET/CT were compared. Subgroup analyses were conducted to assess studies comparing the modalities and studies in which whole-body MRI included DWI. Twelve studies comprising 373 patients were included: six evaluated both modalities, four evaluated whole-body MRI only, and two evaluated FDG PET/CT only. Of studies of MRI, five included DWI. Pooled sensitivity and specificity were 87% (95% CI, 75-93%) and 57% (95% CI, 37-76%) for whole-body MRI versus 64% (95% CI, 45-79%) and 82% (95% CI, 75-88%) for FDG PET/CT (sensitivity, = .29; specificity, = .01). For studies directly comparing the modalities, pooled sensitivity and specificity were 90% (95% CI, 80-100%) and 56% (95% CI, 44-68%) for whole-body MRI versus 66% (95% CI, 47-85%) and 81% (95% CI, 72-90%) for FDG PET/CT (sensitivity, = .18; specificity, < .001). Sensitivity and specificity were 93% (95% CI, 75-98%) and 57% (95% CI, 21-87%) for DWI versus 74% (95% CI, 60-85%) and 56% (95% CI, 38-73%) for whole-body MRI without DWI (sensitivity, = .27; specificity, = .99). The AUC values were 0.84 for whole-body MRI, 0.83 for FDG PET/CT, and 0.92 for DWI. FDG PET/CT had significantly higher specificity, and whole-body MRI had higher sensitivity (though nonsignificant). DWI may contribute to the high sensitivity of whole-body MRI. The results of this meta-analysis suggest potential complementary roles of whole-body MRI and FDG PET/CT in assessment of MM treatment response. Future studies should explore their combination through PET/MRI.
Topics: Fluorodeoxyglucose F18; Humans; Magnetic Resonance Imaging; Multiple Myeloma; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiopharmaceuticals; Sensitivity and Specificity; Whole Body Imaging
PubMed: 34704461
DOI: 10.2214/AJR.21.26381 -
Clinical Nuclear Medicine Apr 2021We performed a systematic review and meta-analysis to evaluate the impact of 18F-FDG PET, PET/CT, and PET/MRI on staging and management during the initial staging of... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
We performed a systematic review and meta-analysis to evaluate the impact of 18F-FDG PET, PET/CT, and PET/MRI on staging and management during the initial staging of breast cancer.
METHODS
We searched the PubMed, Embase, Cochrane Library, and KoreaMed databases until March 2020 to identify studies that reported the proportion of breast cancer patients whose clinical stage or management were changed after PET scans. The proportion of changes was pooled using a random-effects model. Subgroup and metaregression analyses were performed to explore heterogeneity.
RESULTS
We included 29 studies (4276 patients). The pooled proportions of changes in stage and management were 25% (95% confidence interval [CI], 21%-30%) and 18% (95% CI, 14%-23%), respectively. When stage changes were stratified according to initial stage, the pooled proportions were 11% (95% CI, 3%-22%) in stage I, 20% (95% CI, 16%-24%) in stage II, and 34% (95% CI, 27%-42%) in stage III. The relative proportions of intermodality and intention-to-treat changes were 74% and 70%, respectively. Using metaregression analyses, the mean age and the proportion of initial stage III to IV and histologic grade II to III were significant factors affecting the heterogeneity in changes in stage or management.
CONCLUSIONS
Currently available literature suggests that the use of 18F-FDG PET, PET/CT, or PET/MRI leads to significant modification of staging and treatment in newly diagnosed breast cancer patients. Therefore, there may be a role for routine clinical use of PET imaging for the initial staging of breast cancer.
Topics: Breast Neoplasms; Fluorodeoxyglucose F18; Humans; Magnetic Resonance Imaging; Neoplasm Staging; Positron Emission Tomography Computed Tomography
PubMed: 33651022
DOI: 10.1097/RLU.0000000000003502 -
General Thoracic and Cardiovascular... Mar 2022There is a high risk of mortality and morbidity associated with Vascular Graft Infections (VGI) which requires early diagnosis. The aim of the present systematic review... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
There is a high risk of mortality and morbidity associated with Vascular Graft Infections (VGI) which requires early diagnosis. The aim of the present systematic review and meta-analysis was to evaluate the diagnostic accuracy, sensitivity and specificity of 18FDG PET/CT in diagnosing VGI.
METHODS
A systematic review was conducted according to the PRISMA guidelines through a search in Embase, PubMed, and Cochrane databases. We evaluated five parameters including specificity, sensitivity, negative and positive predictive values (NPV and PPV), and accuracy. We used STATA/MP 15.0 (StataCorp, College Station, TX) for all of our analyses.
RESULTS
Overall 10 studies including 320 patients undergone 18FDG PET/CT were included. The sensitivity, specificity, positive and negative likelihood ratios along with their 95% CI were 0.92 (95% CI 0.88-0.95), 0.76 (95% CI 0.76-0.70), 3.49 (95% CI 3.49-2.32) and 0.14 (95% CI 0.09-0.23), respectively. The diagnostic odds ratio (DOR) for diagnosis of VGI was 37.12 (95% CI 14.84-92.82). The mean cut-off value of the maximum standardized uptake value (SUVmax) for diagnosis of VGI was 5.39 while the overall mean SUVmax among patients with VGI was 8.47.
CONCLUSION
According to our results, 18FDG PET/CT is a useful diagnostic method in detecting active VGI with high diagnostic accuracy. Because of its ability to evaluate morphology and main texture using SUVmax, the 18FDG PET/CT provides an objective assessment of aspects and extent of disease activity, which results in preventing unnecessary surgery, proper treatment planning, and evaluating the effectiveness of treatment.
Topics: Fluorodeoxyglucose F18; Humans; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Predictive Value of Tests; Radiopharmaceuticals; Sensitivity and Specificity
PubMed: 34309812
DOI: 10.1007/s11748-021-01682-6 -
Neurological Sciences : Official... Aug 2022Autoimmune encephalitis (AE) is caused by the antibodies that target receptors and intracellular or surface proteins. To achieve the appropriate therapeutic results,... (Review)
Review
INTRODUCTION
Autoimmune encephalitis (AE) is caused by the antibodies that target receptors and intracellular or surface proteins. To achieve the appropriate therapeutic results, early and proper diagnosis is still the most important issue. In this review, we provide an overview of FDG-PET imaging findings in AE patients and possible relation to different subtypes and clinical features.
METHODS
PubMed, Web of Science, and Scopus were searched in August 2021 using a predefined search strategy.
RESULTS
After two-step reviewing, 22 studies with a total of 332 participants were entered into our qualitative synthesis. In anti-NMDAR encephalitis, decreased activity in the occipital lobe was present, in addition, to an increase in frontal, parietal, and specifically medial temporal activity. Anti-VGKC patients showed altered metabolism in cortical and subcortical regions such as striata and cerebellum. Abnormal metabolism in patients with anti-LGI1 has been reported in diverse areas of the brain including medial temporal, hippocampus, cerebellum, and basal ganglia all of which had hypermetabolism. Hypometabolism in parietal, frontal, occipital lobes, temporal, frontal, and hippocampus was observed in AE patients with anti-GAD antibodies.
CONCLUSION
Our results indicate huge diversity in metabolic patterns among different AE subtypes and it is hard to draw a firm conclusion. Moreover, the timing of imaging, seizures, and acute treatments can alter the PET patterns strongly. Further prospective investigations with specific inclusion and exclusion criteria should be carried out to identify the metabolic defect in different AE subtypes.
Topics: Anti-N-Methyl-D-Aspartate Receptor Encephalitis; Autoantibodies; Brain; Encephalitis; Fluorodeoxyglucose F18; Hashimoto Disease; Humans; Magnetic Resonance Imaging; Positron-Emission Tomography
PubMed: 35486333
DOI: 10.1007/s10072-022-06094-9 -
American Journal of Surgery Aug 2022Many patients with Medullary Thyroid Cancer (MTC) will have persistent or recurrent disease after surgery requiring lifelong surveillance with imaging and tumor markers.... (Review)
Review
BACKGROUND
Many patients with Medullary Thyroid Cancer (MTC) will have persistent or recurrent disease after surgery requiring lifelong surveillance with imaging and tumor markers. The objective of this study is to evaluate the efficacy of Ga-DOTATATE-PET (or Ga labelled equivalent radiopharmaceutical) versus F-FDG-PET for detecting persistent and/or metastatic recurrent MTC.
METHODS
Relevant studies were identified by conducting searches in Embase and PubMed and five studies were included in the final review.
RESULTS
Five studies investigated per-patient sensitivity of F-FDG-PET and Ga-DOTATATE-PET in MTC patients. Four studies investigated the correlation between calcitonin and number of lesions detected by F-FDG-PET and Ga-DOTATATE-PET, and three investigated the correlation between CEA and number of lesions detected by F-FDG-PET and Ga-DOTATATE-PET. There was no significant difference in number of lesions detected by F-FDG -PET compared with Ga-DOTATATE-PET.
CONCLUSIONS
When compared directly to F-FDG-PET, there is a general trend towards favoring Ga-DOTATATE-PET in per-patient sensitivities, and incidence of lesion detection.
Topics: Carcinoma, Neuroendocrine; Fluorodeoxyglucose F18; Gallium Radioisotopes; Humans; Positron-Emission Tomography; Radionuclide Imaging; Radiopharmaceuticals; Thyroid Neoplasms
PubMed: 35382933
DOI: 10.1016/j.amjsurg.2022.03.046 -
European Journal of Nuclear Medicine... Sep 2019PET/MRI was introduced for clinical use in 2011 and is now an established modality for the imaging of brain and certain pelvic cancers, whereas clinical use for the...
PURPOSE
PET/MRI was introduced for clinical use in 2011 and is now an established modality for the imaging of brain and certain pelvic cancers, whereas clinical use for the imaging of other forms of cancer is not yet widespread. We therefore systematically investigated what has been published on the use of PET/MRI compared to PET/CT in the imaging of cancers outside the brain, focusing on clinical areas of application related to diagnosis, staging and restaging.
METHODS
A systematic search of PubMed/MEDLINE, Embase and the Cochrane Library was performed. Studies evaluating the diagnostic performance of simultaneous PET/MRI in cancer patients were chosen.
RESULTS
A total of 3,138 publications were identified and 116 published during the period 2012-2018 were included and were grouped according to the major cancer forms: 13 head and neck (HNC), 9 breast (BC), 21 prostate (PC), 14 gynaecological, 13 gastrointestinal (GIC), and 46 various cancers. Data from studies comparing PET/MRI and PET/CT for staging/restaging suggested the superiority of F-FDG PET/MRI for the detection of tumour extension and retropharyngeal lymph node metastases in nasopharyngeal cancer, and for the detection of liver metastases and possibly bone marrow metastases in high-risk BC. FDG PET/MRI tended to be inferior for the detection of lung metastases in HNC and BC. Ga-PSMA-11 PET/MRI was superior to PET/CT for the detection of local PC recurrence. FDG PET/MRI was superior to FDG PET/CT for the detection of local tumour invasion in cervical cancer and had higher accuracy for the detection of liver metastases in colorectal cancer.
CONCLUSION
The scoping review methodology resulted in the identification of a huge number of records, of which less than 5% were suitable for inclusion and only a limited number allowed conclusions on the advantages/disadvantages of PET/MRI compared to PET/CT in the oncological setting. There was evidence to support the use of FDG PET/MRI in staging of nasopharyngeal cancer and high-risk BC. Preliminary data indicate the superiority of PET/MRI for the detection of local recurrence in PC, local tumour invasion in cervical cancer, and liver metastases in colorectal cancer. These conclusions are based on small datasets and need to be further explored.
Topics: Edetic Acid; Fluorodeoxyglucose F18; Gallium Isotopes; Gallium Radioisotopes; Humans; Magnetic Resonance Imaging; Multimodal Imaging; Neoplasm Metastasis; Neoplasms; Oligopeptides; Positron Emission Tomography Computed Tomography; Predictive Value of Tests; Radiopharmaceuticals
PubMed: 31267161
DOI: 10.1007/s00259-019-04402-8 -
Contrast Media & Molecular Imaging 2021The aim of this paper is to compare the diagnostic accuracy of PET/CT, PET/MRI, and the combination of PET/CT and MRI for detecting synchronous cancer and distant... (Meta-Analysis)
Meta-Analysis
Diagnostic Accuracy of Combined PET/CT with MRI, 18F-FDG PET/MRI, and 18F-FDG PET/CT in Patients with Oropharyngeal and Hypopharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.
INTRODUCTION
The aim of this paper is to compare the diagnostic accuracy of PET/CT, PET/MRI, and the combination of PET/CT and MRI for detecting synchronous cancer and distant metastasis in patients with oropharyngeal and hypopharyngeal squamous cell carcinomas (OHSCC).
METHOD
A large and growing body of literature has been conducted using the Preferred Reporting Items for Systematic Reviews (PRISMA). The researchers collected all accessible literature existing through Cochrane Library (John Wiley & Sons) electronic databases, Embase (Elsevier), PubMed (U.S. National Library of Medicine), Scopus, and Google Scholar up to June 2020. Analyses were conducted using Stata version 12.0 (StataCorp LP).
RESULTS
A total of nine studies consisting of 1166 patients were included. The pooled sensitivity of combined PET/CT with MRI, 18F-FDG PET/MRI, and 18F-FDG PET/CT was 0.92, 0.80, and 0.79, respectively, and the corresponding specificities were 0.93, 0.91, and 0.88. The overall prevalence of distant metastases and synchronous cancer in patients with oropharyngeal and hypopharyngeal squamous cell carcinomas was 9.2% and 11.8%, respectively, with the esophagus (4.6%) being the most common site of synchronous cancer. The most common sites of distant metastases were lung (3%), bone (1.2%), and distant lymph nodes (1.2%), respectively.
CONCLUSION
Our study showed an approximately similar diagnostic performance for PET/CT, PET/MRI, and the combination of PET/CT and MRI for metastasis assessment in advanced oropharyngeal and hypopharyngeal squamous cell carcinomas.
Topics: Fluorodeoxyglucose F18; Humans; Lymph Nodes; Lymphatic Metastasis; Magnetic Resonance Imaging; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Squamous Cell Carcinoma of Head and Neck
PubMed: 34007251
DOI: 10.1155/2021/6653117 -
European Journal of Nuclear Medicine... Jan 2021Left ventricular assist devices (LVADs) are increasingly used for the treatment of advanced heart failure. LVADs improve quality of life and decrease mortality, but the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Left ventricular assist devices (LVADs) are increasingly used for the treatment of advanced heart failure. LVADs improve quality of life and decrease mortality, but the driveline carries substantial risk for major infections. These device-related LVAD and driveline infections are difficult to diagnose with conventional imaging. We reviewed and analysed the current literature on the additive value of F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) imaging for the diagnosis of LVAD-related infections."
MATERIALS/METHODS
We performed a systematic literature review using several databases from their inception until the 31st of December, 2019. Studies investigating the diagnostic performance of FDG-PET/CT in patients with suspected LVAD infection were retrieved. After a bias risk assessment using QUADAS-2, a study-aggregate meta-analysis was performed on a per examination-based analysis.
RESULTS
A total of 10 studies were included in the systematic review, eight of which were also eligible for study-aggregate meta-analysis. For the meta-analysis, a total of 256 FDG-PET/CT scans, examining pump/pocket and/or driveline infection, were acquired in 230 patients. Pooled sensitivity of FDG-PET/CT was 0.95 (95% confidence interval (CI) 0.89-0.97) and pooled specificity was 0.91 (95% CI 0.54-0.99) for the diagnosis of device-related infection. For pump/pocket infection, sensitivity and specificity of FDG-PET/CT were 0.97 (95%CI 0.69-1.00) and 0.93 (95%CI 0.64-0.99), respectively. For driveline infection, sensitivity and specificity were 0.96 (95%CI 0.88-0.99) and 0.99 (95%CI 0.13-1.00) respectively. Significant heterogeneity existed across studies for specificity, mostly caused by differences in scan procedures. Predefined criteria for suspicion of LVAD and/or driveline infection were lacking in all included studies.
CONCLUSIONS
FDG-PET/CT is a valuable tool for assessment of device-related infection in LVAD patients, with high sensitivity and high, albeit variable, specificity. Standardization of FDG-PET/CT procedures and criteria for suspected device-related LVAD infections are needed for consistent reporting of FDG-PET/CT scans.
Topics: Fluorodeoxyglucose F18; Heart-Assist Devices; Humans; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Prosthesis-Related Infections; Quality of Life; Radiopharmaceuticals; Sensitivity and Specificity
PubMed: 32594196
DOI: 10.1007/s00259-020-04930-8