Diffusion-weighted MRI versus FDG-PET/CT for diagnosing pancreatic cancer: an indirect comparison meta-analysis

Background Fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) and diffusion-weighted magnetic resonance imaging (DWI or DW-MRI) are tools for the diagnosis of pancreatic cancer. However, comparison of their diagnostic performance remains unknown. Purpose To indirectly compare the diagnostic value of DWI and FDG-PET/CT in the detection of pancreatic cancer. Material and Methods A literature search of PubMed, Embase, and Cochrane Library electronic databases for articles published through May 2018 yielded 875 articles. For the meta-analysis, we included 26 studies evaluating the efficacy of DWI and FDG-PET/CT for determining pancreatic cancer with a total of 1377 patients. QUADAS (Quality Assessment of Diagnostic Accuracy Studies) was used to assess the study quality. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the receiver operating characteristic curves (AUC) with their 95% confidence intervals were calculated for each individual study. Results There were no significant differences between DWI and FDG-PET/CT for sensitivity, specificity, PLR, NLR, or DOR, while DWI AUC was higher than that of FDG-PET/CT for the detection of pancreatic cancer. Conclusion The diagnostic value of both DWI and FDG-PET/CT were comparable and, hence, both techniques seem to be equally useful tools for the diagnosis of pancreatic cancer.

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Diagnostic Performance of 18F-FDG PET/CT in Native Valve Endocarditis: Systematic Review and Bivariate Meta-Analysis

Diagnostics ◽

10.3390/diagnostics10100754 ◽

2020 ◽

Vol 10 (10) ◽

pp. 754

Author(s):

Christel H. Kamani ◽

Gilles Allenbach ◽

Mario Jreige ◽

Anna G. Pavon ◽

Marie Meyer ◽

...

Keyword(s):

Systematic Review ◽

Likelihood Ratio ◽

Fdg Pet ◽

Meta Analysis ◽

Cochrane Library ◽

Native Valve ◽

Native Valve Endocarditis ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Background: Infectious endocarditis is a life-threatening disease, requiring prompt and accurate diagnosis. The aim of this article is to perform a systematic review and meta-analysis of the literature to estimate the performance of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for the diagnosis of native valve endocarditis (NVE). Methods: Selected articles evaluating the diagnostic accuracy of 18F-FDG PET/CT in patients with suspected NVE, resulting from a comprehensive literature search through the PubMed/MEDLINE and Cochrane library databases until April 2020, were included for the systematic review and meta-analysis. Results: Seven studies (351 episodes of suspected NVE) were included. 18F-FDG PET/CT yielded a pooled sensitivity of 36.3% and a pooled specificity of 99.1% for the diagnosis of NVE. The pooled positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 8.3, 0.6, and 15.3, respectively. The sensitivity increased using contemporary PET/CT device with state-of-the-art patient preparation as well as innovative image acquisitions or adding the results of 18F-FDG PET/CT in a multimodality strategy. Conclusions: In our systematic review and meta-analysis, 18F-FDG PET/CT yielded a poor pooled sensitivity with an otherwise excellent pooled specificity for the diagnosis of NVE; however, several factors may increase the sensitivity without affecting the specificity and these factors should be better evaluated in future studies.

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Utility of 18F-FDG PET and PET/CT in diagnosis and staging of chondrosarcoma: a meta-analysis

10.21203/rs.2.16535/v1 ◽

2019 ◽

Author(s):

Qingyu Zhang ◽

Yongming Xi ◽

Dong Li ◽

Zenong Yuan ◽

Jun Dong

Keyword(s):

Likelihood Ratio ◽

Fdg Pet ◽

Clinical Decision Making ◽

Positive Likelihood Ratio ◽

Standardized Uptake Value ◽

Negative Likelihood Ratio ◽

Cochrane Library ◽

Pet Ct ◽

Sensitivity Specificity ◽

Fdg Pet Ct

Abstract Background Chondrosarcoma is the second most common primary bone sarcoma; 18 F-FDG PET and PET/CT are increasingly proposed as tools to evaluate the status of chondrosarcoma but their accuracy remains disputable. The study aims to evaluate the utility of 18 F-FDG PET and PET/CT to differentiate chondrosarcoma from benign cartilaginous lesions and to predict the histopathological grade of chondrosarcoma.Methods A comprehensive search was performed in three electronic databases including Medline/PubMed, the Cochrane library and Embase to retrieve diagnostic studies evaluating the role of 18 F-FDG PET or PET/CT for appraising status of chondrosarcoma. The reference lists of related articles were also scrutinized manually. Useful data were extracted to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odd ratio (DOR), the summary receiver operating characteristic curve (sROC) as well as the area under the curve (AUC) of 18 F-FDG PET or PET/CT in diagnosing chondrosarcoma, and pooled weighted mean differences (WMD) of maximum standardized uptake value (SUVmax) between different entities of cartilaginous neoplasms by using Stata 15.0.Results A total of 12 studies provided sufficient data for the quantitative analysis. For the diagnosis of chondrosarcoma, the pooled sensitivity, specificity and DOR of 18 F-FDG PET were 0.84 (95% confidence interval [CI] 0.46 to 0.97), 0.82 (95% CI 0.55 to 0.94) and 24.244 (95% CI 1.985 to 96.148), respectively while those of 18 F-FDG PET/CT were 0.94 (95% CI 0.86 to 0.97), 0.89 (95% CI 0.82 to 0.93) and 112.999 (95% CI 41.341 to 308.866), respectively. The pooled WMD of SUVmax were -0.89 (95% CI -1.67 to -0.10) between benign cartilaginous lesions and grade 1 (G1) chondrosarcoma, -1.94 (95% CI -2.76 to -1.12) between G1 and grade 2 (G2) chondrosarcoma, and -2.37 (95% CI -5.79 to 1.05) between G2 and grade 3 (G3) chondrosarcoma.Conclusions In a word, 18 F-FDG PET/CT revealed excellent accuracy in the diagnosis of chondrosarcoma and might assist in clinical decision-making. However, SUVmax alone showed restricted ability to differentiate benign cartilaginous lesions and chondrosarcoma, as well as between G2 and G3 chondrosarcoma. More large-scale studies are still needed to further warrant current findings.

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Comparison of the Diagnostic Value of MRI and Whole Body 18F-FDG PET/CT in Diagnosis of Spondylodiscitis

Journal of Clinical Medicine ◽

10.3390/jcm9051581 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1581

Author(s):

Corinna Altini ◽

Valentina Lavelli ◽

Artor Niccoli-Asabella ◽

Angela Sardaro ◽

Alessia Branca ◽

...

Keyword(s):

Fdg Pet ◽

Diagnostic Value ◽

Whole Body ◽

Spine Infection ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Sensitivity Specificity ◽

Fdg Pet Ct ◽

Ct And Mri

Spondylodiscitis is a spine infection for which a diagnosis by a magnetic resonance imaging (MRI) is considered the most appropriate imaging technique. The aim of this study was to compare the role of an 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and an MRI in this field. For 56 patients with suspected spondylodiscitis for whom MRI and 18F-FDG PET/CT were performed, we retrospectively analyzed the results. Cohen’s κ was applied to evaluate the agreement between the two techniques in all patients and in subgroups with a different number of spinal districts analyzed by the MRI. Sensitivity, specificity, and accuracy were also evaluated. The agreements of the 18F-FDG PET/CT and MRI in the evaluation of the entire population, whole-spine MRI, and two-districts MRI were moderate (κ = 0.456, κ = 0.432, and κ = 0.429, respectively). In patients for whom one-district MRI was performed, 18F-FDG PET/CT and MRI were both positive and completely concordant (κ = 1). We also separately evaluated patients with suspected spondylodiscitis caused by Mycobacterium tuberculosis for whom the MRI and 18F-FDG PET/CT were always concordant excepting in 2 of the 18 (11%) patients. Sensitivity, specificity, and accuracy of the MRI and 18F-FDG PET/CT were 100%, 60%, 97%, and 92%, 100%, and 94%, respectively. Our results confirmed the 18F-FDG PET/CT diagnostic value in the diagnosis of spondylodiscitis is comparable to that of MRI for the entire spine evaluation. This could be considered a complementary technique or a valid alternative to MRI.

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Diagnostic value of [18F]FDG-PET/CT in polymyalgia rheumatica: a systematic review and meta-analysis

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-020-05162-6 ◽

2020 ◽

Author(s):

K. S. M. van der Geest ◽

G. Treglia ◽

A. W. J. M. Glaudemans ◽

E. Brouwer ◽

F. Jamar ◽

...

Keyword(s):

Systematic Review ◽

Polymyalgia Rheumatica ◽

Fdg Pet ◽

Meta Analysis ◽

Diagnostic Value ◽

Current Evidence ◽

Interpretation Criteria ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Abstract Purpose Polymyalgia rheumatica (PMR) can be difficult to diagnose. Whole-body [18F]FDG-PET/CT allows for a comprehensive evaluation of all relevant articular and extra-articular structures affected by PMR. We aimed to summarize current evidence on the diagnostic value of [18F]FDG-PET/CT for a diagnosis of PMR. Methods PubMed/MEDLINE and the Cochrane Library database were searched from inception through May 31, 2020. Studies containing patients with PMR who underwent [18F]FDG-PET/CT were included. Screening and full-text review were performed by 3 investigators and data extraction by 2 investigators. Risk of bias was examined with the QUADAS-2 tool. Diagnostic test meta-analysis was performed with a bivariate model. Results Twenty studies were included in the systematic review, of which 9 studies (n = 636 patients) were eligible for meta-analysis. [18F]FDG positivity at the following sites was associated with a diagnosis of PMR: interspinous bursae (positive likelihood ratio (LR+) 4.00; 95% CI 1.84–8.71), hips (LR+ 2.91; 95% CI 2.09–4.05), ischial tuberosities (LR+ 2.86; 95% CI 1.91–4.28), shoulders (LR+ 2.57; 95% CI 1.24–5.32) and sternoclavicular joints (LR+ 2.31; 95% CI 1.33–4.02). Negative likelihood ratios (LR−) for these sites, as well as the greater trochanters, were all less than 0.50. Composite [18F]FDG-PET/CT scores, as reported in 3 studies, provided a pooled LR+ of 3.91 (95% CI 2.42–6.32) and LR− of 0.19 (95% CI 0.10–0.36). Moderate to high heterogeneity was observed across the studies, mainly due to differences in patient selection, scanning procedures and/or interpretation criteria. Conclusion Significant [18F]FDG uptake at a combination of anatomic sites is informative for a diagnosis of PMR. [18F]FDG-PET/CT might be an important diagnostic tool in patients with suspected PMR. This study also highlights the need for adherence to published procedural recommendations and standardized interpretation criteria for the use of [18F]FDG-PET/CT in PMR.

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Differential Diagnostic Value of Bilateral Inferior Petrosal Sinus Sampling (BIPSS) in ACTH-Dependent Cushing Syndrome: a Systematic Review and Meta-Analysis

10.21203/rs.2.21469/v1 ◽

2020 ◽

Author(s):

Hao Wang ◽

Ying Ba ◽

Qian Xing ◽

Run-Ce Cai

Keyword(s):

Differential Diagnosis ◽

Likelihood Ratio ◽

Cushing Syndrome ◽

Meta Analysis ◽

Diagnostic Value ◽

Cochrane Library ◽

Published Data ◽

Inferior Petrosal Sinus ◽

Inferior Petrosal Sinus Sampling ◽

Sensitivity Specificity

Abstract Background: Previous studies have shown inconsistent results in the differential diagnosis obtained from bilateral inferior petrosal sinus sampling (BIPSS) in adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome. This meta-analysis evaluated the diagnostic value of BIPSS via the published literature. Methods: This study searched PubMed, Embase, Web of Science, the Cochrane library, and the Wanfang database for published data on the differential diagnosis obtained using BIPSS in Cushing syndrome as of October 2019. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and receiver operating characteristic (ROC) curves were calculated based on the relevant data. Results: This meta-analysis included a total of 23 studies with 1,617 patients. The calculated sensitivity, specificity, PLR, and NLR were 0.94 (95% confidence interval, CI: 0.91–0.96), 0.89 (95% CI: 0.79–0.95), 8.8 (95% CI: 4.3–17.9), and 0.07 (95% CI: 0.04–0.11), respectively. The pooled DOR and area under the ROC curve were 129 (95% CI: 48–345) and 0.97 (95% CI: 0.95–0.98), respectively. Conclusion: This meta-analysis indicated that BIPSS had a highly diagnostic value for ACTH originally in patients with ACTH-dependent Cushing syndrome, and BIPSS should be used as a routine method to identify ACTH sources. Keywords: Bilateral inferior petrosal sinus sampling, ACTH-dependent Cushing syndrome, Differential diagnosis , Diagnostic meta-analysis

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High Diagnostic Value of 18F-FDG PET/CT in Endometrial Cancer: Systematic Review and Meta-Analysis of the Literature

Journal of Nuclear Medicine ◽

10.2967/jnumed.115.170597 ◽

2016 ◽

Vol 57 (6) ◽

pp. 879-885 ◽

Cited By ~ 43

Author(s):

V. R. Bollineni ◽

S. Ytre-Hauge ◽

O. Bollineni-Balabay ◽

H. B. Salvesen ◽

I. S. Haldorsen

Keyword(s):

Systematic Review ◽

Endometrial Cancer ◽

Fdg Pet ◽

Meta Analysis ◽

Diagnostic Value ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Diagnostic performance of PET in thyroid cancer with elevated anti-Tg Ab

Endocrine Related Cancer ◽

10.1530/erc-17-0341 ◽

2018 ◽

Vol 25 (6) ◽

pp. 643-652 ◽

Cited By ~ 4

Author(s):

Seong-Jang Kim ◽

Sang-Woo Lee ◽

Kyoungjune Pak ◽

Sung-Ryul Shim

Keyword(s):

Thyroid Cancer ◽

Likelihood Ratio ◽

Fdg Pet ◽

Diagnostic Performance ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Whole Body ◽

Cochrane Library ◽

Pet Ct ◽

Fdg Pet Ct

We aimed to explore the role of the diagnostic accuracy of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for the detection of recurrent and/or metastatic diseases in differentiated thyroid cancer (DTC) patients with progressively and/or persistently elevated TgAb levels and negative radioactive iodine whole-body scan (RI-WBS) through a systematic review and meta-analysis. The MEDLINE, EMBASE and Cochrane Library database, from the earliest available date of indexing through June 30, 2017, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for the detection of recurrent and/or metastatic diseases in DTC patients with progressively and/or persistently elevated TgAb levels and negative RI-WBS. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR−). Across 9 studies (515 patients), the pooled sensitivity for F-18 FDG PET/CT was 0.84 (95% CI; 0.77–0.89) a pooled specificity of 0.78 (95% CI; 0.67–0.86). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 3.8 (95% CI; 2.5–5.7) and negative likelihood ratio (LR−) of 0.21 (95% CI; 0.14–0.30). The pooled diagnostic odds ratio (DOR) was 18 (95% CI; 10–34). The area (AUC) under the hierarchical summary receiver-operating characteristic (HCROC) curve was 0.88 (95% CI: 0.85–0.90). F-18 FDG PET or PET/CT demonstrated moderate sensitivity and specificity for the detection of recurrent and/or metastatic diseases in DTC patients with progressively and/or persistently elevated TgAb levels and negative RI-WBS.

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