Combined FDG-PET/CT for the detection of unknown primary tumors: systematic review and meta-analysis

Abstract Background FDG-PET/CT is increasingly used for oncologic and inflammatory diseases. Focal incidental FDG uptake occurs rarely in breast tissue but has often significant consequences. This study aimed to systematically review literature regarding focal incidental breast uptake (FIBU) on FDG-PET/CT in order to yield an update on the prevalence and risk of malignancy for FIBU. Methods A systematic search for relevant articles published between 2012 and 2018 was performed through MEDLINE, Embase, and Cochrane databases. Studies addressing the detection of FIBU in patients without a previous history of breast malignancy were included. The QUADAS-2 was used for quality assessment, and eligible data were pooled using a fixed-effects model. I2 was calculated for the heterogeneity between studies. Results Eight studies containing 180,002 scans were included in the systematic review. The median prevalence of FIBU for both genders was 0.52% (range 0.18–22.5%). Prevalence for women was mentioned separately in five studies and varied from 0.51 to 23.5%. One study reporting a high prevalence was based on patients being staged for known malignancy, and the word “breast” was used in the search, which may have caused selection bias. Data from four studies were eligible for meta-analysis. A high degree of heterogeneity was observed for prevalence data (I2 of 97.5%), while moderate heterogeneity was observed for data on malignancy risk assessment (I2 of 62.8%). The pooled prevalence of FIBU in women was 0.61% (range 0.56–0.66%), and the pooled prevalence of malignancy of FIBUs was 38.7% (range 34.4–43.0%). The most commonly detected malignancy was invasive ductal carcinoma. Conclusion FIBU occurs rarely on FDG-PET/CT for female patients but yields a high risk of malignancy according to the results of published papers. Therefore, it should be considered relevant to further elucidate patients with incidentally detected FDG uptake in breast in clinical practice.

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FDG PET/CT versus somatostatin receptor PET/CT in TENIS syndrome: a systematic review and meta-analysis

Clinical and Translational Imaging ◽

10.1007/s40336-020-00390-0 ◽

2020 ◽

Vol 8 (5) ◽

pp. 365-375

Author(s):

Felipe Alves Mourato ◽

Maria Amorim Almeida ◽

Ana Emília Teixeira Brito ◽

Aline Lopes Garcia Leal ◽

Paulo Almeida Filho ◽

...

Keyword(s):

Systematic Review ◽

Fdg Pet ◽

Meta Analysis ◽

Somatostatin Receptor ◽

Pet Ct ◽

Fdg Pet Ct

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Diagnostic performance of FDG PET/CT in critically ill patients with suspected infection: A systematic review and meta-analysis

Journal of the Formosan Medical Association ◽

10.1016/j.jfma.2019.09.010 ◽

2020 ◽

Vol 119 (5) ◽

pp. 941-949 ◽

Cited By ~ 1

Author(s):

Chun-Kai Huang ◽

Jei-Yie Huang ◽

Sheng-Yuan Ruan ◽

Kuo-Liong Chien

Keyword(s):

Systematic Review ◽

Critically Ill ◽

Critically Ill Patients ◽

Fdg Pet ◽

Diagnostic Performance ◽

Meta Analysis ◽

Suspected Infection ◽

Pet Ct ◽

Fdg Pet Ct

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The accuracy of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in the staging of newly diagnosed nasopharyngeal carcinoma: A systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.5553 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 5553-5553

Author(s):

Balamurugan A. Vellayappan ◽

Yu Yang Soon ◽

Arul Earnest ◽

Qing Zhang ◽

Wee Yao Koh ◽

...

Keyword(s):

Systematic Review ◽

Nasopharyngeal Carcinoma ◽

Fdg Pet ◽

Meta Analysis ◽

Newly Diagnosed ◽

Pet Ct ◽

Q Index ◽

T Classification ◽

Fdg Pet Ct ◽

Sensitivity Estimate

5553 Background: The specific role of FDG-PET/CT in pretreatment staging of nasopharyngeal carcinoma (NPC) remains to be validated. We performed a systematic review and meta-analysis to assess the diagnostic accuracy of staging FDG-PET/CT for newly diagnosed NPC with reference to conventional staging modalities and/or clinical follow up. Methods: We searched MEDLINE, Cochrane central register of controlled trials, proceedings of ASTRO and ASCO as well as Chinese databases (Chinese National Knowledge Infrastructure and CBMdisc) from the date of inception to September 2011 for relevant studies. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) checklist. We determined the sensitivities and specificities across studies, pooled diagnostic odds ratios (DOR) and constructed summary receiver operating characteristic curves using hierarchical regression model. Results: We found 15 relevant studies (of which seven were in English) including 851 patients. Of the 15 studies: five addressed primary tumor (T), nine addressed regional lymph nodes (N) and seven addressed distant metastasis (M). The combined sensitivity estimate for FDG-PET/CT in T classification was 0.77(95% confidence interval (CI) 0.59-0.95). The combined sensitivity estimate for N classification was 0.88 (95% CI 0.86-0.90), specificity 0.85(95% CI 0.83-0.88), DOR 82.4 (23.2 to 292.6) and Q-index was 0.90. For M classification, the combined sensitivity estimate was 0.82(95% CI 0.65-0.93), specificity 0.98 (95% CI 0.96 – 0.99), DOR 120.9 (43.0 to 340.0) and Q-index was 0.89. Conclusions: FDG-PET/CT showed good accuracy in N and M but not T classification for newly diagnosed pre-treated NPC. FDG-PET/CT, together with Magnetic resonance imaging (MRI) of the nasopharynx, should be part of the routine staging investigations for NPC. Future research should evaluate the accuracy of FDG-PET/MRI fusion as a single staging modality for NPC.

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