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Current Medical Imaging 2022The Non-Small Cell Variant of Lung Cancer (NSCLC) has a poorer prognosis. It is typically diagnosed through non-invasive imaging. Of particular note has been FDGPET/ CT,... (Meta-Analysis)
Meta-Analysis
Diagnostic Accuracy of F18-fluorodeoxyglucose Positron Emission Tomography- computed Tomography for the Detection of Non-small Cell Lung Cancer Recurrence: A Systematic Review and Meta-analysis.
BACKGROUND
The Non-Small Cell Variant of Lung Cancer (NSCLC) has a poorer prognosis. It is typically diagnosed through non-invasive imaging. Of particular note has been FDGPET/ CT, which has been investigated across various settings with differing results.
OBJECTIVE
This study is to pool the available information on the diagnostic performance of 18-F FDG PET/CT for detecting NSCLC recurrence.
METHODS
A systematic literature search was conducted across electronic databases for studies published before May 2021. The QUADAS tool was applied to assess study quality, and a metaanalysis was performed to retrieve pooled estimates. Chi-squared tests and I2 statistics were used to assess heterogeneity. Egger's test and funnel plots were used to assess publication bias.
RESULTS
The literature search yielded 20 studies featuring data on 1,973 patients. The majority of the studies had a low bias risk. The pooled sensitivity and specificity were 96% (95% CI: 91%- 98%) and 93% (95% CI: 89%-95%), respectively. The LRP and LRN estimates were in the left upper quadrant of the LR scattergram, indicating that F18-FDG PET/CT can be utilized for both confirmation and exclusion. The AUC was 0.98 (95% CI: 0.92-0.99). Fagan's nomogram showed that F18-FDG PET/CT had good clinical utility for recurrent NSCLC diagnosis. There was considerable between-study variability (p=0.02). The funnel plot was asymmetrical, indicating the possibility of publication bias.
CONCLUSION
This meta-analysis found FDG-PET/CT to be highly accurate for identifying NSCLC recurrence. However, more studies assessing this modality across different patient situations are required to strengthen the argument for changing international guidelines and practices.
Topics: Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Carcinoma, Non-Small-Cell Lung; Radiopharmaceuticals; Lung Neoplasms; Tomography, X-Ray Computed; Positron-Emission Tomography
PubMed: 35927894
DOI: 10.2174/1573405618666220802101446 -
Stroke Aug 2019Background and Purpose- The clinical utility of positron emission tomography (PET) imaging in evaluating carotid artery plaque vulnerability remains unclear. Two tracers... (Meta-Analysis)
Meta-Analysis
Background and Purpose- The clinical utility of positron emission tomography (PET) imaging in evaluating carotid artery plaque vulnerability remains unclear. Two tracers of recent interest for carotid plaque imaging are F-fluorodeoxyglucose (F-FDG) and F-sodium fluoride (F-NaF). We performed a systematic review and meta-analysis evaluating the association between carotid artery F-FDG or F-NaF uptake and recent or future cerebral ischemic events. Methods- A systematic review of Ovid MEDLINE, Ovid EMBASE, and the Cochrane library was conducted from inception to December 2017 for articles evaluating PET tracer uptake in recently symptomatic versus asymptomatic carotid arteries, and articles evaluating carotid uptake in relation to future ischemic events. Cerebral ischemic events were defined as ipsilateral strokes, transient ischemic attacks, or amaurosis fugax. We quantitatively pooled studies by a random-effects model when 3 or more studies were amenable for analysis. We assessed the standardized mean difference between tracer uptake in the symptomatic versus asymptomatic carotid artery using Cohen's d metric. Results- After screening 4144 unique articles, 13 prospective cohort studies assessing carotid artery F-FDG uptake in patients with recent cerebral ischemia were eligible for review. Eleven cohorts of 290 subjects scanned with F-FDG were eligible for meta-analysis. We found that carotid arteries ipsilateral to recent ischemic events had significantly higher F-FDG uptake than asymptomatic arteries (Cohen's d =0.492; CI=0.130-0.855; P=0.008) as well as significant heterogeneity (Cochran's Q =31.5; P=0.0005; I=68.3%). Meta-regression was not performed due to the limited number of studies in the analysis. Only 2 studies investigating F-NaF PET imaging, and another 2 articles investigating ischemic event recurrence were found. Conclusions- Recent ipsilateral cerebral ischemia may be associated with increased carotid F-FDG uptake on PET imaging regardless of degree of carotid stenosis, although significant heterogeneity was found, and these results should be interpreted with caution. Emerging evidence suggests a similar association may be present with F-NaF plaque uptake. More studies are warranted to provide definitive conclusions on the utility of F-FDG or F-NaF in carotid plaque evaluation before investigating carotid PET as a diagnostic tool for cerebral ischemic events.
Topics: Brain Ischemia; Carotid Stenosis; Humans; Neuroimaging; Plaque, Atherosclerotic; Positron-Emission Tomography
PubMed: 31272325
DOI: 10.1161/STROKEAHA.118.023987 -
TheScientificWorldJournal 2014The diagnostic performance of positron emission tomography using (18)F-fluorodeoxyglucose (FDG-PET) in detecting nodal involvement in patients with anal canal cancer... (Meta-Analysis)
Meta-Analysis Review
Diagnostic performance of positron emission tomography/computed tomography using fluorine-18 fluorodeoxyglucose in detecting locoregional nodal involvement in patients with anal canal cancer: a systematic review and meta-analysis.
PURPOSE
The diagnostic performance of positron emission tomography using (18)F-fluorodeoxyglucose (FDG-PET) in detecting nodal involvement in patients with anal canal cancer (ACC) has been investigated by several studies with conflicting results. The aim of our study is to systematically review and meta-analyze published data about this topic.
METHODS
A comprehensive computer literature search of PubMed/MEDLINE, Scopus, and Embase databases was carried out on July 10 to find relevant articles concerning the diagnostic performance of FDG-PET in detecting locoregional nodal involvement in patients with ACC. No language restriction was used. Pooled diagnostic performance on a lesion-based analysis was calculated.
RESULTS
Seven retrospective and five prospective studies have been reviewed. Six studies allowed assessing pooled sensitivity; five studies allowed assessing pooled specificity. Sensitivity and specificity values of FDG-PET/CT on a lesion-based analysis ranged from 31 to 100% and from 53 to 98%, with pooled estimates of 56% (95% CI: 45-67%) and 90% (95% CI: 86-93%), respectively.
CONCLUSIONS
Our meta-analysis demonstrates that FDG-PET is a specific diagnostic tool in detecting locoregional lymph node involvement in patients with ACC. Low sensitivity is a major concern; however, higher sensitivity could be reached combining FDG-PET with MR scan.
Topics: Anus Neoplasms; Fluorodeoxyglucose F18; Humans; Lymphatic Metastasis; Multimodal Imaging; Positron-Emission Tomography; Tomography, X-Ray Computed
PubMed: 24672298
DOI: 10.1155/2014/196068 -
Hellenic Journal of Nuclear Medicine 2020A meta-analysis was performed to compare the diagnostic performance of gallium-68 (Ga) somatostatin receptor positron emission tomography (Ga-SSTR PET) and... (Meta-Analysis)
Meta-Analysis
Comparison of gallium-68 somatostatin receptor and F-fluorodeoxyglucose positron emission tomography in the diagnosis of neuroendocrine tumours: A systematic review and meta-analysis.
OBJECTIVE
A meta-analysis was performed to compare the diagnostic performance of gallium-68 (Ga) somatostatin receptor positron emission tomography (Ga-SSTR PET) and fluorine-18-fluorodeoxyglucose (F-FDG) PET in patients with neuroendocrine tumours (NET) and whether the two imaging modalities can be mutually substituted in clinical work.
METHODS
We performed electronic literature searches of the MEDLINE, PubMed, Embase and Cochrane Library databases for English-language articles from the earliest available date of indexing through 30 July 2019. We calculated the pooled sensitivity, specificity and diagnostic odds ratios (DOR) with 95% confidence intervals (95% CI) of Ga-SSTR PET and F-FDG PET in NET. We drew a summary receiver operator characteristic (SROC) curve and calculated the area under the curve (AUC) to measure the accuracy of Ga-SSTR PET and F-FDG PET in patients or lesions with NET.
RESULTS
Thirty studies comprising 3401 patients and 5793 lesions with NET were included in this meta-analysis. The pooled sensitivity, sensitivity, DOR and AUC for Ga-SSTR PET or PET/computed tomography (CT) in the diagnosis of NET, based on lesion patient, were 0.92(0.89-0.95), 0.91(0.83-0.95),119(51-282) and 0.96(0.94-0.98), and based on lesion, were 0.95(0.86-0.98), 0.93(0.83-0.97), 229(43-1205) and 0.98(0.96-0.99), respectively. The pooled sensitivity, sensitivity, DOR and AUC for F-FDG PET or PET/CT in NET were 0.70(0.41-0.89), 0.97(0.70-1.00), 67(7-612) and 0.94(0.92-0.96), respectively, when analyzed on a per-patient basis.The pooled sensitivities of Ga-SSTR PET/CT were 0.923 (95% CI: 0.884-0.952), 0.902 (0.862-0.934) and 0.578 (0.482-0.669) in the G1(ki67,≤2%), G2(ki67,>3%,≤20% and G3(ki67,>20%) groups based on patients with NET, respectively. The pooled sensitivities of F-FDG PET/CT were 0.378 (0.319-0.440), 0.554 (0.492-0.615) and 0.712 (0.633-0.783) in the G1, G2 and G3 groups based on patients with NET, respectively.
CONCLUSION
The Ga-SSTR PET has highly sensitive and had a greater diagnostic value than F-FDG PET for patients with NET. Fluorine-18-FDG PET, however, had significant specificity than Ga-SSTR PET. The Ga-SSTR has high sensitivity in G1/G2 NET, while F-FDG has a low positive rate. In G3 NET, however, the opposite is true. Therefore, the Ga-SSTR PET and F-FDG PET modalities are complementary rather than substitutive in clinical practice.
Topics: Fluorodeoxyglucose F18; Gallium Radioisotopes; Humans; Neuroendocrine Tumors; Positron-Emission Tomography; Receptors, Somatostatin
PubMed: 32716410
DOI: 10.1967/s002449912108 -
Chinese Medical Journal May 2017Diagnosis of syphilis is difficult. Follow-up and therapy evaluation of syphilitic patients are poor. Little is known about positron emission tomography (PET) in... (Review)
Review
BACKGROUND
Diagnosis of syphilis is difficult. Follow-up and therapy evaluation of syphilitic patients are poor. Little is known about positron emission tomography (PET) in syphilis. This review was to systematically review usefulness of PET for diagnosis, disease extent evaluation, follow-up, and treatment response assessment in patients with syphilis.
METHODS
We searched PubMed, EMBASE, SCOPUS, Cochrane Library, Web of Science, ClinicalTrials.gov, and three Chinese databases (SinoMed, Wanfang, and CNKI) for English and Chinese language articles from inception to September 2016. We also collected potentially relevant studies and reviews using a manual search. The search keywords included the combined text and MeSH terms "syphilis" and "positron emission tomography". We included studies that reporting syphilis with a PET scan before and/or after antibiotic treatment. The diagnosis of syphilis was based on serological criteria or dark field microscopy. Outcomes include pre- and post-treatment PET scan, pre- and post-treatment computed tomography, and pre- and post-treatment magnetic resonance imaging. We excluded the articles not published in English or Chinese or not involving humans.
RESULTS
Of 258 identified articles, 34 observational studies were included. Thirty-three studies were single-patient case reports and one study was a small case series. All patients were adults. The mean age of patients was 48.3 ± 12.1 years. In primary syphilis, increased fluorodeoxyglucose (FDG) accumulation could be seen at the site of inoculation or in the regional lymph nodes. In secondary syphilis with lung, bone, gastrointestinal involvement, or generalized lymphadenopathy, increased FDG uptake was the most commonly detected changes. In tertiary syphilis, increased glucose metabolic activity, hypometabolic lesions, or normal glucose uptake might be seen on PET. There were five types of PET scans in neurosyphilis. A repeated PET scan after treatment revealed apparent or complete resolution of the asymmetry of radiotracer uptake.
CONCLUSION
PET is helpful in targeting diagnostic interventions, characterizing disease extent, assessing nodal involvement, and treatment efficacy for syphilis.
Topics: Fluorodeoxyglucose F18; Humans; Positron-Emission Tomography; Syphilis
PubMed: 28469107
DOI: 10.4103/0366-6999.204940 -
BioMed Research International 2014To meta-analyze published data about the diagnostic performance of fluorine-18-Fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) and PET/computed... (Meta-Analysis)
Meta-Analysis Review
Diagnostic performance of fluorine-18-fluorodeoxyglucose positron emission tomography in the postchemotherapy management of patients with seminoma: systematic review and meta-analysis.
OBJECTIVE
To meta-analyze published data about the diagnostic performance of fluorine-18-Fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) and PET/computed tomography (PET/CT) in the postchemotherapy management of patients with seminoma.
METHODS
A comprehensive literature search of studies published through January 2014 on this topic was performed. All retrieved studies were reviewed and qualitatively analyzed. Pooled sensitivity and specificity, positive and negative predictive values (PPV and NPV), accuracy, and area under the summary ROC curve (AUC) of (18)F-FDG-PET or PET/CT on a per examination-based analysis were calculated. Subgroup analyses considering the size of residual/recurrent lesions were carried out.
RESULTS
Nine studies including 375 scans were selected. The pooled analysis provided the following results: sensitivity 78% (95% confidence interval (95% CI): 67-87%), specificity 86% (95% CI: 81-89%), PPV 58% (95% CI: 48-68%), NPV 94% (95% CI: 90-96%), and accuracy 84% (95% CI: 80-88%). The AUC was 0.90. A better diagnostic accuracy of (18)F-FDG-PET or PET/CT in evaluating residual/recurrent lesions >3 cm compared to those <3 cm was found.
CONCLUSIONS
(18)F-FDG-PET and PET/CT were demonstrated to be accurate imaging methods in the postchemotherapy management of patients with seminoma; nevertheless possible sources of false-negative and false-positive results should be considered. The literature focusing on this setting still remains limited and cost-effectiveness analyses are warranted.
Topics: Fluorodeoxyglucose F18; Humans; Male; Monitoring, Physiologic; Positron-Emission Tomography; Radiography; Radiopharmaceuticals; Seminoma; Testicular Neoplasms
PubMed: 24963486
DOI: 10.1155/2014/852681 -
Clinical Lymphoma, Myeloma & Leukemia Aug 2021This review aimed to assess diagnostic performance of 18F-flouro-deoxy-glucose positron emission tomography (FDG-PET) with or without computed tomography (CT) scan in... (Meta-Analysis)
Meta-Analysis
Diagnostic Performance of Pretreatment 18F-Fluorodeoxyglucose Positron Emission Tomography With or Without Computed Tomography in Patients With Primary Central Nervous System Lymphoma: Updated Systematic Review and Diagnostic Test Accuracy Meta-analyses.
This review aimed to assess diagnostic performance of 18F-flouro-deoxy-glucose positron emission tomography (FDG-PET) with or without computed tomography (CT) scan in primary central nervous system lymphoma (PCNSL). Eligible studies reporting diagnostic accuracy of pretreatment FDG-PET(CT) scan in immunocompetent adults with PCNSL were identified through systematic literature search. Data on diagnostic performance from individual studies was summarized in a 2 × 2 table classifying patients as true positives, true negatives, false positives, and false negatives using histopathologic diagnosis as reference standard. Random-effects model was used to calculate weighted-mean pooled sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic odds ratio with 95% confidence intervals (95% CI). Twenty-nine primary studies involving 967 patients were included. Weighted-mean pooled sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic odds ratio was 87% (95% CI, 83%-90%), 85% (95% CI, 81%-88%), 84% (95% CI, 81%-88%), 87% (95% CI, 84%-90%), and 29.78 (95% CI, 18.34-48.35), respectively, demonstrating acceptably high diagnostic accuracy of pretreatment FDG-PET(CT) scan in immunocompetent patients with PCNSL.
Topics: Central Nervous System Neoplasms; Fluorodeoxyglucose F18; Humans; Lymphoma, Non-Hodgkin; Neuroimaging; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Predictive Value of Tests; Radiopharmaceuticals; Sensitivity and Specificity
PubMed: 33947632
DOI: 10.1016/j.clml.2021.03.011 -
Medicine Jul 2018Distinguishing glioma recurrence from the necrosis after radiation therapy and/or chemotherapy is a crucial clinical issue, for the different diagnosis will lead to... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Distinguishing glioma recurrence from the necrosis after radiation therapy and/or chemotherapy is a crucial clinical issue, for the different diagnosis will lead to divergent treatments. The accurate judgment is barely achieved by conventional imaging methods. We therefore assume it is of need to exert a meta-analysis to evaluate the diagnostic accuracy of 11C-choline positron emission tomography (PET), to achieve this goal.
MATERIAL AND METHODS
We searched the PubMed, Embase, and Chinese Biomedical databases comprehensively to select eligible studies and assessed the quality of each article included (up to May 31, 2018). Fixed-effects models were used. Summary diagnostic accuracy of 11C-choline PET was obtained from pooled analysis.
RESULTS
Five articles comprising 6 studies with total 118 patients (134 scans) were enrolled for the meta-analysis. There was no heterogeneity or publication bias among the included studies. The pooled sensitivity and specificity were 0.87 (95% confidence interval [CI]: 0.78, 0.93) and 0.820 (95% CI: 0.69, 0.91), respectively. The pooled diagnostic odds ratio was 35.50 (95% CI: 11.70, 107.75). The area under the curve was 0.9170 (95% CI: 0.8504, 0.9836), with Q* index equaling to 0.8499. The diagnostic accuracy of each subgroup showed no statistical differences with that of the overall group.
CONCLUSIONS
This meta-analysis indicated 11C-choline has high diagnostic accuracy for the identification of tumor relapse from radiation induced necrosis in gliomas.
Topics: Carbon Radioisotopes; Choline; Diagnosis, Differential; Glioma; Humans; Necrosis; Neoplasm Recurrence, Local; Positron-Emission Tomography; Radiation Injuries; Radiopharmaceuticals; Sensitivity and Specificity
PubMed: 30024551
DOI: 10.1097/MD.0000000000011556 -
Revista Da Associacao Medica Brasileira... 2023
Meta-Analysis
Topics: Humans; Female; Breast Neoplasms; Tomography, X-Ray Computed; Positron-Emission Tomography; Radiopharmaceuticals; Patients; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography
PubMed: 37556635
DOI: 10.1590/1806-9282.2023S116 -
Journal of Gynecologic Oncology Sep 2019To perform a systematic review and meta-analysis of the prognostic value of post-treatment ¹⁸F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET) in... (Meta-Analysis)
Meta-Analysis
Prognostic value of post-treatment ¹⁸F-fluorodeoxyglucose positron emission tomography in uterine cervical cancer patients treated with radiotherapy: a systematic review and meta-analysis.
OBJECTIVES
To perform a systematic review and meta-analysis of the prognostic value of post-treatment ¹⁸F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET) in uterine cervical cancer patients treated with radiotherapy (RT) with or without chemotherapy.
METHODS
PubMed and Embase databases were searched up to July 22, 2018, for studies which evaluated the response outcomes of ¹⁸F-FDG PET following RT, and their prognostic significance in uterine cervical cancer was assessed with overall survival (OS) or progression-free survival (PFS) as endpoints. Hazard ratios (HRs) were meta-analytically pooled using the random-effects model.
RESULTS
Eleven studies with 12 patient cohorts including 1,104 patients were included. For a quantitative synthesis of OS, 7 cohorts were included. Two cohorts which reported disease-specific survival instead of OS were also included with flexibility. Pooled HR of complete metabolic response (CMR) compared to partial metabolic response (PMR) was 0.19 (95% confidence interval [CI]=0.11-0.31). Pooled HR of CMR compared to progressive metabolic disease (PMD) was more evident at 0.07 (95% CI=0.04-0.12), and that of CMR compared to both PMR and PMD was 0.20 (95% CI=0.12-0.34). Quantitative synthesis for PFS was performed with a total of 8 cohorts. Pooled HR of CMR was 0.17 (95% CI=0.10-0.29) compared to PMR, 0.02 (95% CI=0.01-0.06) compared to PMD and 0.12 (95% CI=0.07-0.19) compared to both PMR and PMD.
CONCLUSION
Response results of post-RT ¹⁸F-FDG PET were significant prognostic factors in patients with uterine cervical cancer, and ¹⁸F-FDG PET could be a reasonable follow-up imaging modality.
Topics: Cohort Studies; Female; Fluorodeoxyglucose F18; Humans; Middle Aged; Positron-Emission Tomography; Prognosis; Radiopharmaceuticals; Uterine Cervical Neoplasms
PubMed: 31328452
DOI: 10.3802/jgo.2019.30.e66