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European Urology Open Science Apr 2023Prostate cancer (PCa) remains one of the leading causes of cancer-related deaths in men worldwide. Men at risk are typically offered multiparametric magnetic resonance...
A Systematic Review of the Variability in Performing and Reporting Intraprostatic Prostate-specific Membrane Antigen Positron Emission Tomography in Primary Staging Studies.
CONTEXT
Prostate cancer (PCa) remains one of the leading causes of cancer-related deaths in men worldwide. Men at risk are typically offered multiparametric magnetic resonance imaging and, if suspicious, a targeted biopsy. However, false-negative rates of magnetic resonance imaging are consistently 18%; therefore, there is growing interest in improving the diagnostic performance of imaging through novel technologies. Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is being utilised for PCa staging and, more recently, for intraprostatic tumour localisation. However, significant variability has been observed in how PSMA PET is performed and reported.
OBJECTIVE
In this review, we aim to evaluate how pervasive this variability is in trials investigating the performance of PSMA PET in primary PCa workup.
EVIDENCE ACQUISITION
Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, we performed an optimal search in five different databases. After removing duplicates, 65 studies were included in our review.
EVIDENCE SYNTHESIS
Studies dated back as early as 2016, with numerous different source countries. There was variation in the reference standard for PSMA PET, with some using biopsy specimens or surgical specimens, and in some cases, a combination of the two. Similar inconsistencies were noted when studies selected histological definitions of clinically significant PCa, while some omitted their definition altogether. The most significant variations in performing PSMA PET were the radiotracer type, dose, acquisition time after injection, and the PET camera being utilised. Substantial variation in the reporting of PSMA PET was noted, with no consistency in defining what constitutes a positive intraprostatic lesion. Across 65 studies, four different definitions were used.
CONCLUSIONS
This systematic review has highlighted considerable variation in obtaining and performing a PSMA PET study in the context of primary PCa diagnosis. Given the discrepancy in how PSMA PET was performed and reported, it questions the homogony of studies from centre to centre. Standardisation of PSMA PET is required for this to become a consistently useful and reproducible modality in the diagnosis of PCa.
PATIENT SUMMARY
Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is being utilised for staging and localisation of prostate cancer (PCa); however, there is significant variability in performing and reporting PSMA PET. Standardisation of PSMA PET is required for results to be consistently useful and reproducible for the diagnosis of PCa.
PubMed: 37101769
DOI: 10.1016/j.euros.2023.01.010 -
Systematic Reviews Dec 2012The aim of this systematic review was to systematically assess the potential patient-relevant benefit (primary aim) and diagnostic and prognostic accuracy (secondary... (Review)
Review
F-18-fluoro-2-deoxyglucose positron emission tomography (PET) and PET/computed tomography imaging in primary staging of patients with malignant melanoma: a systematic review.
PURPOSE
The aim of this systematic review was to systematically assess the potential patient-relevant benefit (primary aim) and diagnostic and prognostic accuracy (secondary aim) of positron emission tomography (PET) and PET/computed tomography (CT) in primary staging of malignant melanoma. This systematic review updates the previous evidence for PET(/CT) in malignant melanoma.
MATERIALS AND METHODS
For the first aim, randomized controlled trials (RCTs) investigating patient-relevant outcomes and comparing PET and PET(/CT) with each other or with conventional imaging were considered. For the secondary aim, a review of reviews was conducted, which was amended by an update search for primary studies. MEDLINE, EMBASE and four databases of the Cochrane Library were searched. The risk of bias was assessed using a modified QUADAS tool.
RESULTS
No RCTs investigating the patient-relevant benefit of PET(/CT) and no prognostic accuracy studies were found. Seventeen diagnostic accuracy studies of varying quality were identified. For patients with American Joint Committee on Cancer (AJCC) stages I and II, sensitivity mostly ranged from 0 to 67%. Specificity ranged from 77 to 100%. For AJCC stages III and IV, sensitivity ranged from 68 to 87% and specificity from 92 to 98%.
CONCLUSION
There is currently no evidence of a patient-relevant benefit of PET(/CT) in the primary staging of malignant melanoma. RCTs investigating patient-relevant outcomes are therefore required. The diagnostic accuracy of PET(/CT) appears to increase with higher AJCC stages.
Topics: Fluorodeoxyglucose F18; Humans; Melanoma; Multimodal Imaging; Neoplasm Staging; Positron-Emission Tomography; Radiopharmaceuticals; Randomized Controlled Trials as Topic; Skin Neoplasms; Tomography, X-Ray Computed
PubMed: 23237499
DOI: 10.1186/2046-4053-1-62 -
Revista de NeurologiaA great deal of controversy has arisen about the role positron emission tomography (PET) has to play in the diagnostic assessment of Alzheimer s disease (AD). AIMS. The... (Review)
Review
INTRODUCTION
A great deal of controversy has arisen about the role positron emission tomography (PET) has to play in the diagnostic assessment of Alzheimer s disease (AD). AIMS. The objective of this study is to review, assess and synthesize existing evidence about the value of PET in the prediction of the progression towards dementia undergone by subjects with mild cognitive impairment and in the differential diagnosis of AD from other types of dementia.
DEVELOPMENT
We performed a systematic review with explicit search criteria in primary and secondary databases in order to locate documents that could serve our research purposes. Selection and assessment of the quality of the documents found was performed according to a set of pre established criteria. The search for secondary sources yielded nine technical reports, a clinical guideline and a systematic review. To sum up their conclusions it would appear that little work has been published, it is of poor quality and the findings are against the routine use of this technology. The search in primary sources produced three original scientific papers dealing with its value in prediction and two others that referred to differential diagnosis; this new evidence did not, however, modify the previous conclusions.
CONCLUSIONS
At present, and according to available evidence, the routine use of PET cannot be recommended in the diagnostic assessment of AD. The number of original works available is very low and, generally speaking, they offer important methodological limitations.
Topics: Alzheimer Disease; Clinical Trials as Topic; Diagnosis, Differential; Evaluation Studies as Topic; Evidence-Based Medicine; Female; Humans; MEDLINE; Male; Research Design; Tomography, Emission-Computed
PubMed: 14606055
DOI: No ID Found -
Health Technology Assessment... Sep 2011In the UK, colorectal cancer (CRC) is the third most common malignancy (behind lung and breast cancer) with 37,514 cases registered in 2006: around two-thirds (23,384)... (Review)
Review
OBJECTIVES
In the UK, colorectal cancer (CRC) is the third most common malignancy (behind lung and breast cancer) with 37,514 cases registered in 2006: around two-thirds (23,384) in the colon and one-third (14,130) in the rectum. Treatment of cancers of the colon can vary considerably, but surgical resection is the mainstay of treatment for curative intent. Following surgical resection, there is a comprehensive assessment of the tumour, it's invasion characteristics and spread (tumour staging). A number of imaging modalities are used in the pre-operative staging of CRCs including; computerised tomography (CT), magnetic resonance imaging, ultrasound imaging and positron emission tomography (PET). This report examines the role of CT in combination with PET scanning (PET/CT 'hybrid' scan). The research objectives are: to evaluate the diagnostic accuracy and therapeutic impact of fluorine-18-deoxyglucose (FDG) PET/CT for the pre-operative staging of primary, recurrent and metastatic cancer using systematic review methods; undertake probabilistic decision-analytic modelling (using Monte Carlo simulation); and conduct a value of information analysis to help inform whether or not there is potential worth in undertaking further research.
DATA SOURCES
For each aspect of the research - the systematic review, the handsearch study and the economic evaluation - a database was assembled from a comprehensive search for published and unpublished studies, which included database searches, reference lists search and contact with experts. In the systematic review prospective and retrospective patient series (diagnostic cohort) and randomised controlled trials (RCTs) were eligible for inclusion. Both consecutive series and series that are not explicitly reported as consecutive were included.
REVIEW METHODS
Two reviewers extracted all data and applied the criteria independently and resolved disagreements by discussion. Data to populate 2 × 2 contingency tables consisting of the number of true positives, true negatives, false positives and false negatives using the studies' own definitions were extracted, as were data relating to changes in management. Fourteen items from the Quality Assessment of Diagnostic Accuracy Studies checklist were used to assess the methodological quality of the included studies. Patient-level data were used to calculate sensitivity and specificity with confidence intervals (CIs). Data were plotted graphically in forest plots. For the economic evaluation, economic models were designed for each of the disease states: primary, recurrent and metastatic. These were developed and populated based on a variety of information sources (in particular from published data sources) and literature, and in consultation with clinical experts.
RESULTS
The review found 30 studies that met the eligibility criteria. Only two small studies evaluated the use of FDG PET/CT in primary CRC, and there is insufficient evidence to support its routine use at this time. The use of FDG PET/CT for the detection of recurrent disease identified data from five retrospective studies from which a pooled sensitivity of 91% (95% CI 0.87% to 0.95%) and specificity of 91% (95% CI 0.85% to 0.95%) were observed. Pooled accuracy data from patients undergoing staging for suspected metastatic disease showed FDG PET/CT to have a pooled sensitivity of 91% (95% CI 87% to 94%) and a specificity of 76% (95% CI 58% to 88%), but the poor quality of the studies means the validity of the data may be compromised by several biases. The separate handsearch study did not yield any additional unique studies relevant to FDG PET/CT. Models for recurrent disease demonstrated an incremental cost-effectiveness ratio of £ 21,409 per quality-adjusted life-year (QALY) for rectal cancer, £ 6189 per QALY for colon cancer and £ 21,434 per QALY for metastatic disease. The value of handsearching to identify studies of less clearly defined or reported diagnostic tests is still to be investigated.
CONCLUSIONS
The systematic review found insufficient evidence to support the routine use of FDG PET/CT in primary CRC and only a small amount of evidence supporting its use in the pre-operative staging of recurrent and metastatic CRC, and, although FDG PET/CT was shown to change patient management, the data are divergent and the quality of research is generally poor. The handsearch to identify studies of less clearly defined or reported diagnostic tests did not find additional studies. The primary limitations in the economic evaluations were due to uncertainty and lack of available evidence from the systematic reviews for key parameters in each of the five models. In order to address this, a conservative approach was adopted in choosing DTA estimates for the model parameters. Probabilistic analyses were undertaken for each of the models, incorporating wide levels of uncertainty particularly for the DTA estimates. None of the economic models reported cost-savings, but the approach adopted was conservative in order to determine more reliable results given the lack of current information. The economic evaluations conclude that FDG PET/CT as an add-on imaging device is cost-effective in the pre-operative staging of recurrent colon, recurrent rectal and metastatic disease but not in primary colon or rectal cancers. There would be value in undertaking an RCT with a concurrent economic evaluation to evaluate the therapeutic impact and cost-effectiveness of FDG PET/CT compared with conventional imaging (without PET) for the pre-operative staging of recurrent and metastatic CRC.
Topics: Cohort Studies; Colorectal Neoplasms; Cost-Benefit Analysis; Fluorodeoxyglucose F18; Humans; Monte Carlo Method; Multimodal Imaging; Neoplasm Staging; Positron-Emission Tomography; Preoperative Period; Quality-Adjusted Life Years; Radiopharmaceuticals; Randomized Controlled Trials as Topic; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 21958472
DOI: 10.3310/hta15350 -
World Neurosurgery May 2023When magnetic resonance imaging (MRI) fails to detect an underlying epileptogenic lesion, the odds of a good outcome after epilepsy surgery are significantly lower... (Meta-Analysis)
Meta-Analysis Review
Seizure Outcome After Surgery for Refractory Epilepsy Diagnosed by F-fluorodeoxyglucose positron emission tomography (F-FDG PET/MRI): A Systematic Review and Meta-Analysis.
OBJECTIVE
When magnetic resonance imaging (MRI) fails to detect an underlying epileptogenic lesion, the odds of a good outcome after epilepsy surgery are significantly lower (20%-65% compared with 60%-90% if a lesion is detected). We investigated the possible effects of introducing hybrid F-fluorodeoxyglucose positron emission tomography (F-FDG PET)/MRI into the decision algorithm for patients with lesioned and nonlesioned drug-resistant epilepsy.
METHODS
Three databases were searched from January 1990 to October 2022. We registered the protocol with International Platform of Registered Systematic Review and Meta-analysis Protocols. Studies in which F-FDG PET/MRI was conducted with ≥12 months of postsurgical follow-up in patients with refractory epilepsy. Random-effects meta-analysis was used to calculate the proportion of patients with good outcomes. Metaregression was used to investigate sources of heterogeneity.
RESULTS
We identified 8105 studies, of which 23 (1292 patients in total) were included. The overall good postoperative outcome rate was 71% (95% confidence interval 63.6-74.9). Good outcome was associated with the location of the refractory epileptic lesion (temporal lobe or extratemporal; risk ratio 1.27 [95% confidence interval 1.01-1.52], P = 0.009); Length of postoperative follow-up ≥40 months included in the same study accounted for 0.6% of the observed heterogeneity.
CONCLUSIONS
Seventy-one percent of patients with refractory epilepsy and F-FDG PET/MRI epileptogenic lesion features had a good outcome of epilepsy after surgery. Our findings can be incorporated into routine preoperative consultations and emphasize the importance of the complete resection of the temporal lobe epileptogenic zone for F-FDG PET/MRI detection when safe and feasible.
Topics: Humans; Fluorodeoxyglucose F18; Drug Resistant Epilepsy; Electroencephalography; Seizures; Positron-Emission Tomography; Epilepsy; Magnetic Resonance Imaging; Epilepsy, Temporal Lobe
PubMed: 36746239
DOI: 10.1016/j.wneu.2023.01.114 -
European Journal of Cancer (Oxford,... Dec 2021Cancers of unknown primary (CUP) have traditionally been treated empirically, with a dismal prognosis. Compared with standard diagnostic tests, including CT and MRI,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cancers of unknown primary (CUP) have traditionally been treated empirically, with a dismal prognosis. Compared with standard diagnostic tests, including CT and MRI, imaging with F-fluorodeoxyglucose (FDG) PET or PET/CT has shown the capacity to better identify the primary tumour site and detect additional sites of metastasis. However, its clinical impact is not well established. We performed a systematic review and meta-analysis of prior studies to assess the impact of FDG-PET or PET/CT on the management of patients with CUP.
MATERIALS AND METHODS
Pubmed and EMBASE databases were searched up to 4th February 2021. Studies that reported the proportion of patients with CUP who experienced a management change after FDG-PET or PET/ computed tomography (CT) were included and the proportions were pooled using the random-effects model. Study quality was assessed using QUADAS-2. Subgroup analysis was conducted to explore heterogeneity.
RESULTS
Thirty-eight studies (involving 2795 patients) were included. The pooled proportion of patients with management changes was 35% (95% confidence interval 31%-40%). There was substantial heterogeneity among the studies (Q-test, p < 0.01; I = 82%). The specific reason for management change was more commonly detection of the primary site (22% [95% CI 18-28%]) than detection of additional metastatic sites (14% [95% CI 10-19%]). The pooled proportions of patients with management changes were similar among numerous subgroups (range, 32.8%-38.2%).
CONCLUSION
FDG-PET or PET/CT had a meaningful impact on the management of patients with CUP. Approximately, a third of patients had their management changed because of FDG-PET or PET/CT results, and this finding was consistent across numerous subgroups.
Topics: Fluorodeoxyglucose F18; Humans; Neoplasms, Unknown Primary; Positron-Emission Tomography; Radiopharmaceuticals
PubMed: 34742159
DOI: 10.1016/j.ejca.2021.09.031 -
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 -
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 -
European Journal of Medicinal Chemistry Jan 2024Prostate specific membrane antigen (PSMA) has been the subject of several studies in recent decades as a promising molecular target for prostate cancer (PCa), in fact it... (Review)
Review
Prostate specific membrane antigen (PSMA) has been the subject of several studies in recent decades as a promising molecular target for prostate cancer (PCa), in fact it is considered an excellent molecular target for both PCa imaging (both for staging and follow-up), by means of PET/CT and for radioligand therapy. Its interesting molecular features have enabled the development of a new diagnostic and therapeutic approach for PCa, called "theranostics." Considering the abundance of PSMA-based probes that have appeared so far in the literature, the present work focuses the attention on radiopharmaceuticals with increasing clinical application, highlighting advantages and disadvantages in terms of different metabolization and excretion processes, pharmacokinetic, binding affinity and variable internalization rate, tumor-to-background ratio, residence times and toxicity profile.
Topics: Male; Humans; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms; Radiopharmaceuticals; Precision Medicine; Gallium Radioisotopes
PubMed: 37992520
DOI: 10.1016/j.ejmech.2023.115966 -
The Cochrane Database of Systematic... Oct 2018Ovarian cancer is the leading cause of death from gynaecological cancer in developed countries. Surgery and chemotherapy are considered its mainstay of treatment and the... (Meta-Analysis)
Meta-Analysis
Positron emission tomography (PET) and magnetic resonance imaging (MRI) for assessing tumour resectability in advanced epithelial ovarian/fallopian tube/primary peritoneal cancer.
BACKGROUND
Ovarian cancer is the leading cause of death from gynaecological cancer in developed countries. Surgery and chemotherapy are considered its mainstay of treatment and the completeness of surgery is a major prognostic factor for survival in these women. Currently, computed tomography (CT) is used to preoperatively assess tumour resectability. If considered feasible, women will be scheduled for primary debulking surgery (i.e. surgical efforts to remove the bulk of tumour with the aim of leaving no visible (macroscopic) tumour). If primary debulking is not considered feasible (i.e. the tumour load is too extensive), women will receive neoadjuvant chemotherapy to reduce tumour load and subsequently undergo (interval) surgery. However, CT is imperfect in assessing tumour resectability, so additional imaging modalities can be considered to optimise treatment selection.
OBJECTIVES
To assess the diagnostic accuracy of fluorodeoxyglucose-18 (FDG) PET/CT, conventional and diffusion-weighted (DW) MRI as replacement or add-on to abdominal CT, for assessing tumour resectability at primary debulking surgery in women with stage III to IV epithelial ovarian/fallopian tube/primary peritoneal cancer.
SEARCH METHODS
We searched MEDLINE and Embase (OVID) for potential eligible studies (1946 to 23 February 2017). Additionally, ClinicalTrials.gov, WHO-ICTRP and the reference list of all relevant studies were searched.
SELECTION CRITERIA
Diagnostic accuracy studies addressing the accuracy of preoperative FDG-PET/CT, conventional or DW-MRI on assessing tumour resectability in women with advanced stage (III to IV) epithelial ovarian/fallopian tube/primary peritoneal cancer who are scheduled to undergo primary debulking surgery.
DATA COLLECTION AND ANALYSIS
Two authors independently screened titles and abstracts for relevance and inclusion, extracted data and performed methodological quality assessment using QUADAS-2. The limited number of studies did not permit meta-analyses.
MAIN RESULTS
Five studies (544 participants) were included in the analysis. All studies performed the index test as replacement of abdominal CT. Two studies (366 participants) addressed the accuracy of FDG-PET/CT for assessing incomplete debulking with residual disease of any size (> 0 cm) with sensitivities of 1.0 (95% CI 0.54 to 1.0) and 0.66 (95% CI 0.60 to 0.73) and specificities of 1.0 (95% CI 0.80 to 1.0) and 0.88 (95% CI 0.80 to 0.93), respectively (low- and moderate-certainty evidence). Three studies (178 participants) investigated MRI for different target conditions, of which two investigated DW-MRI and one conventional MRI. The first study showed that DW-MRI determines incomplete debulking with residual disease of any size with a sensitivity of 0.94 (95% CI 0.83 to 0.99) and a specificity of 0.98 (95% CI 0.88 to 1.00) (low- and moderate-certainty evidence). For abdominal CT, the sensitivity for assessing incomplete debulking was 0.66 (95% CI 0.52 to 0.78) and the specificity 0.77 (95% CI 0.63 to 0.87) (low- and low-certainty evidence). The second study reported a sensitivity of DW-MRI of 0.75 (95% CI 0.35 to 0.97) and a specificity of 0.96 (95% CI 0.80 to 1.00) (very low-certainty evidence) for assessing incomplete debulking with residual disease > 1 cm. In the last study, the sensitivity for assessing incomplete debulking with residual disease of > 2 cm on conventional MRI was 0.91 (95% CI 0.59 to 1.00) and the specificity 0.97 (95% CI 0.87 to 1.00) (very low-certainty evidence). Overall, the certainty of evidence was very low to moderate (according to GRADE), mainly due to small sample sizes and imprecision.
AUTHORS' CONCLUSIONS
Studies suggested a high specificity and moderate sensitivity for FDG-PET/CT and MRI to assess macroscopic incomplete debulking. However, the certainty of the evidence was insufficient to advise routine addition of FDG-PET/CT or MRI to clinical practice..In a research setting, adding an alternative imaging method could be considered for women identified as suitable for primary debulking by abdominal CT, in an attempt to filter out false-negatives (i.e. debulking, feasible based on abdominal CT, unfeasible at actual surgery).
Topics: Diffusion Magnetic Resonance Imaging; Fallopian Tube Neoplasms; Feasibility Studies; Female; Fluorodeoxyglucose F18; Humans; Neoplasm, Residual; Ovarian Neoplasms; Peritoneal Neoplasms; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Randomized Controlled Trials as Topic; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 30298516
DOI: 10.1002/14651858.CD012567.pub2