Diagnostic Accuracy of F-18 FDG PET/CT for Preoperative Lymph Node Staging in Newly Diagnosed Bladder Cancer Patients: A Systematic Review and Meta-Analysis

Oncology ◽  
2018 ◽  
Vol 95 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Hong Ku Ha ◽  
Phillip J. Koo ◽  
Seong-Jang Kim
2019 ◽  
Vol 92 (1101) ◽  
pp. 20190193 ◽  
Author(s):  
Seong-Jang Kim ◽  
Sang Woo Lee

Objectives: The purpose of the current study was to investiagte the diagnostic accuracy of 18F flucholine (FCH) positron emission tomography/CT (PET/CT) for pre-operative lymph node (LN) staging in newly diagnosed prostate cancer (PCa) patients using meta-analysis. Methods: PubMed and Embase from the earliest available date of indexing through December 31, 2018, were searched for studies evaluating the diagnostic performance of 18F FCH PET/CT for preoperative LN staging in newly diagnosed PCa. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR + and LR-), and constructed summary receiver operating characteristic curves. Results: Across seven studies (627 patients), the pooled sensitivity was 0.57 [95% confidence interval (CI) (0.42–0.70)] and a pooled specificity of 0.94 [95% CI (0.89–0.97)]. Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 10.2 (95% CI; 5.0–21.0) and negative likelihood ratio (LR-) of 0.46 (95% CI; 0.33–0.64). The pooled diagnostic odds ratio was 22 (95% CI; 9–54). Conclusions: 18F FCH PET/CT shows a low sensitivity and high specificity for the detection of metastatic LNs in patients with newly diagnosed PCa. Also, 18F FCH PET/CT is only useful for confirmation of LN metastasis (when positive) in PCa patients. Advances in knowledge: 18F FCH PET/CT demonstrates low sensitivity but high specificity for diagnosis of metastatic LNs in patients with newly diagnosed PCa. Also, 18F FCH PET/CT is only useful for confirmation of LN metastasis (when positive) in PCa patients.


2014 ◽  
Vol 39 (5) ◽  
pp. e308-e312 ◽  
Author(s):  
Eugenio Brunocilla ◽  
Francesco Ceci ◽  
Riccardo Schiavina ◽  
Paolo Castellucci ◽  
Anna Margherita Maffione ◽  
...  

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5553-5553
Author(s):  
Balamurugan A. Vellayappan ◽  
Yu Yang Soon ◽  
Arul Earnest ◽  
Qing Zhang ◽  
Wee Yao Koh ◽  
...  

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.


2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 275-275 ◽  
Author(s):  
Julius van Essen ◽  
Joachim Grosse ◽  
David J. K. P. Pfister ◽  
Robin Epplen ◽  
Axel Heidenreich

275 Background: Radical cystectomy with extended pelvic lymphadenectomy (EPLA) is the treatment of choice for muscle-invasive bladder cancer. For preoperative staging computed tomography and magnetic resonance imaging of the abdomen and the small pelvis are most commonly used in daily routine.Since the aforementioned methods, have a low sensitivity to detect local lymph node metastasis (LNM) we have prospectively evaluated the role of FDG – PET/CT for locoregional staging. Methods: In 27 patients (n = 27) with known invasive urothelial carcinoma or squamous cell carcinoma of the bladder a staging FDG – PET - CT was performed 1-2 days prior to radical cystectomy with EPLA. Subsequently, the results of the histopathological work-up of lymph node specimens and their anatomical localisations were correlated to the FDG-PET/CT findings. Total of 452 lymph nodes were removed, on average ≈ 16.7 per patient. Results: In 3/27 (11.1%) patients LNM were detected in histopathology. 2 patients showed one positive lymph node, 1 patient had two LNM. In two of these patients, the FDG-PET/CT showed an increased enrichment of FDG in projection to the corresponding histologically positive LN. One false negative and one false positive result of FDG-PET/CT were found. Calculated based on the patient population, the following statistics were calculated: Sensitivity (SENS) 66%, specificity (SPEC) 95.8%, positive predictive value (PPV) 66%, negative predictive value (NPV) 95.8%. Related to the absolute number of LN (n = 452), the following numbers were calculated: SENS 75% SPEC 98.7, PPV 37.5%, NPV 99.7%. Conclusions: To date, few studies have been conducted with regard to FDG-PET/CT and its role in locoregional staging. The reported specificity and NPV was between 86% and 100%, sensitivity and PPV were between 50% and 100%. Our results demonstrate specificity and NPV values of larger than 90% and make FDG-PET/CT a valuable staging tool to potentially identify patients with negative nodes in whom EPLA could be safely ommitted. Curently, routine use of PET CT scans can not be recommended and it is currently tested in a prospective multicenter study including a larger patient cohort.


2016 ◽  
Vol 58 (7) ◽  
pp. 1031-1036 ◽  
Author(s):  
Sara Sheikhbahaei ◽  
Charles V. Marcus ◽  
Roberto S. Fragomeni ◽  
Steven P. Rowe ◽  
Mehrbod S. Javadi ◽  
...  

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