scholarly journals Response rate and diagnostic accuracy of PET/CT during and after neo-adjuvant therapies in oesophageal adenocarcinoma: protocol for a systematic review

2020 ◽  
Author(s):  
Jacqueline Jeffries ◽  
Bernadette Coles ◽  
Kevin Bradley ◽  
Alex Holborow ◽  
Elizabeth Smyth ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Surgical Resection ◽  
Adjuvant Treatment ◽  
Response Rate ◽  
Meta Analysis ◽  
Response Rates ◽  
Oesophageal Adenocarcinoma ◽  
Cochrane Library ◽  
Pet Ct

Abstract Background Oesophageal cancer is increasing in incidence and has a poor prognosis. Patients with potentially curable disease have a staging positron emission tomography (PET) examination combined with a computed tomography (CT) to assess loco-regional and distant disease. Although a small proportion of patients are suitable for attempted surgical resection, the majority will receive neo-adjuvant therapy (chemotherapy with or without radiotherapy) before their operation. The current regimen prescribes all patients to complete the neo-adjuvant treatment prior to surgery, but some patients will not experience a beneficial response. A repeat PET/CT after one cycle of neo-adjuvant treatment may identify early response or non-response and could alter subsequent management. The purpose of this systematic review and meta-analysis is to estimate the early and completion response rate defined by fluorodeoxyglucose (FDG)-PET, its diagnostic accuracy and explore associated factors. Methods Primary studies reporting response rates and diagnostic accuracy of PET/CT will be identified from MEDLINE, Embase, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science, International Clinical Trials Registry Platform (ICTRP) Search Portal and ClinicalTrials.gov databases. Peer-reviewed studies published from 2005 onwards will be included. Data will be extracted from selected studies and a meta-analysis using a random effects model will be attempted. Pooled early and completion response rates, and diagnostic accuracy (sensitivity and specificity), will be calculated from available data. Heterogeneity between studies, risk of bias and methodological quality will be assessed. Discussion This systematic review and meta-analysis will identify and synthesise evidence to determine early and completion response rates to neo-adjuvant treatment and the corresponding diagnostic accuracy of PET/CT. This strategy has the potential to identify patients that will not respond to the treatment and to offer this group an alternative pre-operative treatment or proceed directly to operation, thereby avoiding a delay in surgical resection and optimising patient outcomes.

scholarly journals Response rate and diagnostic accuracy of early PET/CT during neo-adjuvant therapies in oesophageal adenocarcinoma: protocol for a systematic review

2020 ◽  
Author(s):  
Jacqueline Jeffries ◽  
Bernadette Coles ◽  
Kevin Bradley ◽  
Alex Holborow ◽  
Elizabeth Smyth ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adjuvant Therapy ◽  
Diagnostic Accuracy ◽  
Response Rate ◽  
Metabolic Response ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Early Response ◽  
Oesophageal Adenocarcinoma ◽  
Pet Ct

Abstract Background Patients with potentially curable oesophageal adenocarcinoma have a staging positron emission tomography (PET) examination combined with a computed tomography (CT) to assess loco-regional and distant disease. Although only 20-30% of patients are suitable for surgical resection, the majority receive neo-adjuvant therapy (chemotherapy with or without radiotherapy) before their operation. However, less than 25% experience any clinically meaningful benefit from the neo-adjuvant therapy. A repeat PET/CT after one cycle of treatment can assess for early metabolic response but remains exploratory. Patients without an early response could be offered alternative treatment strategies. The purpose of this systematic review and meta-analysis is to estimate the early response rate defined by PET/CT, its diagnostic accuracy and explore associated factors. Methods Primary studies reporting response rates and diagnostic accuracy of PET/CT will be identified from MEDLINE, Embase, Cochrane Library, Scopus, Web of Science, International Clinical Trials Registry Platform (ICTRP) Search Portal and ClinicalTrials.gov databases. Peer-reviewed randomised control trials, observational cohort, cross-sectional and case-control studies reporting original response rate data, published from 2005 onwards will be included. Studies recruiting mixed cohorts and with PET/CT repeated after more than one neo-adjuvant treatment cycle will be excluded. The reference standard will be pathological response, defined by either validated Becker or Mandard tumour regression grade (TRG) classifications. The primary outcome will be metabolic response rate after one neo-adjuvant treatment cycle, defined by a reduction in maximum standardised uptake value (SUVmax) of 35%. Secondary outcome will be the sensitivity and specificity of early metabolic response to predict pathological response at this SUVmax reduction threshold. Pooled early response rate, sensitivity and specificity will be calculated using a random effects model with data extracted from selected studies. Heterogeneity between studies, risk of bias and methodological quality will be assessed. Discussion This systematic review and meta-analysis will identify and synthesise evidence to determine early response rates to neo-adjuvant therapies and the corresponding diagnostic accuracy of PET/CT to guide future clinical trials. This strategy could identify patients that will not respond to neo-adjuvant therapy and to offer this group alternative treatment strategies. Systematic review registration: PROSPERO (registration number CRD42019147034)

scholarly journals Diagnostic Performance of PET or PET/CT Using 18F-FDG Labeled White Blood Cells in Infectious Diseases: A Systematic Review and a Bivariate Meta-Analysis

Diagnostics ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. 60 ◽  
Author(s):  
Marie Meyer ◽  
Nathalie Testart ◽  
Mario Jreige ◽  
Christel Kamani ◽  
Mohammed Moshebah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Infectious Diseases ◽  
Diagnostic Accuracy ◽  
Blood Cells ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
White Blood Cells ◽  
Cochrane Library ◽  
Pet Ct ◽  
18F Fdg

Background: Diagnostic performance of positron emission tomography using white blood cells labeled with fluorine-18-fluorodeoxyglucose (18F-FDG-WBC PET or PET/CT) in patients with suspicious infectious diseases has been evaluated in several studies; however, there is no consensus about the diagnostic accuracy of this method. Therefore, a systematic review and meta-analysis was carried out on this topic. Methods: A comprehensive computer literature search screening PubMed/MEDLINE, Embase and Cochrane library databases through March 2019 was performed. Pooled sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR−), and diagnostic odds ratio (DOR) of 18F-FDG-WBC PET or PET/CT in patients with infectious diseases were calculated. Results: Eight studies on the use of 18F-FDG-WBC PET or PET/CT in suspicious infectious diseases were discussed in the systematic review. The meta-analysis of seven studies (236 patients) provided these pooled results on a per patient-based analysis: sensitivity was 86.3% [95% confidence interval (95%CI) 75–92.9%], specificity 92% (95%CI 79.8–97.1%), LR+ 6.6 (95%CI: 3.1–14.1), LR− 0.2 (95%CI: 0.12–0.33), DOR 43.5 (95%CI: 12.2–155). A statistically significant heterogeneity was not detected. Conclusions: Despite limited literature data, 18F-FDG-WBC PET or PET/CT demonstrated a good diagnostic accuracy for the diagnosis of infectious diseases; nevertheless, larger studies are needed.

scholarly journals Diagnostic Role of 18F-PSMA-1007 PET/CT in Prostate Cancer Staging: A Systematic Review

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 552
Author(s):  
Salam Awenat ◽  
Arnoldo Piccardo ◽  
Patricia Carvoeiras ◽  
Giovanni Signore ◽  
Luca Giovanella ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Metastatic Disease ◽  
Cancer Staging ◽  
Relevant Information ◽  
Cochrane Library ◽  
Number Of Patients ◽  
Pet Ct

Background: The use of prostate-specific membrane antigen (PSMA)-targeted agents for staging prostate cancer (PCa) patients using positron emission tomography/computed tomography (PET/CT) is increasing worldwide. We performed a systematic review on the role of 18F-PSMA-1007 PET/CT in PCa staging to provide evidence-based data in this setting. Methods: A comprehensive computer literature search of PubMed/MEDLINE and Cochrane Library databases for studies using 18F-PSMA-1007 PET/CT in PCa staging was performed until 31 December 2020. Eligible articles were selected and relevant information was extracted from the original articles by two authors independently. Results: Eight articles (369 patients) evaluating the role of 18F-PSMA-1007 PET/CT in PCa staging were selected. These studies were quite heterogeneous, but, overall, they demonstrated a good diagnostic accuracy of 18F-PSMA-1007 PET/CT in detecting PCa lesions at staging. Overall, higher primary PCa aggressiveness was associated with higher 18F-PSMA-1007 uptake. When compared with other radiological and scintigraphic imaging methods, 18F-PSMA-1007 PET/CT had superior sensitivity in detecting metastatic disease and the highest inter-reader agreement. 18F-PSMA-1007 PET/CT showed similar results in terms of diagnostic accuracy for PCa staging compared with PET/CT with other PSMA-targeted tracers. Dual imaging with multi-parametric magnetic resonance imaging and 18F-PSMA-1007 PET/CT may improve staging of primary PCa. Notably, 18F-PSMA-1007-PET/CT may detect metastatic disease in a significant number of patients with negative standard imaging. Conclusions: 18F-PSMA-1007 PET/CT demonstrated a good accuracy in PCa staging, with similar results compared with other PSMA-targeted radiopharmaceuticals. This method could substitute bone scintigraphy and conventional abdominal imaging for PCa staging. Prospective multicentric studies are needed to confirm these findings.

scholarly journals CGRP-antibodies, topiramate and botulinum toxin type A in episodic and chronic migraine: A systematic review and meta-analysis

Cephalalgia ◽  
2021 ◽  
pp. 033310242110181
Author(s):  
Florian Frank ◽  
Hanno Ulmer ◽  
Victoria Sidoroff ◽  
Gregor Broessner
Keyword(s):  
Systematic Review ◽  
Monoclonal Antibodies ◽  
Botulinum Toxin ◽  
Response Rate ◽  
Meta Analysis ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Response Rates ◽  
Botulinum Toxin Type ◽  
Odds Ratios

Background The approval of monoclonal antibodies for prevention of migraine has revolutionized treatment for patients. Oral preventatives are still considered first line treatments as head-to-head trials comparing them with antibodies are lacking. Methods The main purpose of this study was to provide a comparative overview of the efficacy of three commonly prescribed migraine preventative medication classes. For this systematic review and meta-analysis, we searched the databases CENTRAL, EMBASE, and MEDLINE until 20 March 2020. We included RCTs reporting the 50% response rates for topiramate, Botulinum Toxin Type A and monoclonal antibodies against CGRP(r). Studies were excluded if response rates were not reported, treatment allocation was unclear, or if study quality was insufficient. Primary outcome measure were the 50% response rates. The pooled odds ratios with 95% confidence intervals were calculated with the random effects model. The study was registered at PROSPERO (CRD42020222880). Findings We identified 6552 reports. Thirty-two were eligible for our review. Studies assessing monoclonal antibodies included 13,302 patients and yielded pooled odds ratios for the 50% response rate of 2.30 (CI: 2.11–2.50). Topiramate had an overall effect estimate of 2.70 (CI: 1.97–3.69) with 1989 included patients and Botulinum Toxin Type A achieved 1.28 (CI: 0.98–1. 67) with 2472 patients included. Interpretation Topiramate, botulinum toxin type A and monoclonal antibodies showed higher odds ratios in achieving a 50% response rate compared to placebo. Topiramate numerically demonstrated the greatest effect size but also the highest drop-out rate.

scholarly journals Performance of 18F-DCFPyL PET/CT Imaging in Early Detection of Biochemically Recurrent Prostate Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Jiale Sun ◽  
Yuxin Lin ◽  
Xuedong Wei ◽  
Jun Ouyang ◽  
Yuhua Huang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Early Detection ◽  
Publication Bias ◽  
Detection Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Recurrent Prostate Cancer ◽  
Pet Ct ◽  
Statistical Heterogeneity

Background: Prostate-specific membrane antigen (PSMA)-targeted 2-(3-{1-carboxy-5-[(6-[18F] fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL) positron emission tomography/computed tomography (PET/CT) has shown advantages in primary staging, restaging, and metastasis detection of prostate cancer (PCa). However, little is known about the role of 18F-DCFPyL PET/CT in biochemically recurrent prostate cancer (BRPCa). Hence, we performed a systematic review and meta-analysis to evaluate 18F-DCFPyL PET/CT as first-line imaging modality in early detection of BRPCa.Methods: A comprehensive literature search of PubMed, Web of Science, Embase, and Cochrane Library was conducted until December 2020. The pooled detection rate on a per-person basis and together with 95% confidence interval (CI) was calculated. Furthermore, a prostate-specific antigen (PSA)-stratified performance of detection positivity was obtained to assess the sensitivity of 18F-DCFPyL PET/CT in BRPCa with different PSA levels.Results: A total of nine eligible studies (844 patients) were included in this meta-analysis. The pooled detection rate (DR) of 18F-DCFPyL PET/CT in BRPCa was 81% (95% CI: 76.9–85.1%). The pooled DR was 88.8% for PSA ≥ 0.5 ng/ml (95% CI: 86.2–91.3%) and 47.2% for PSA < 0.5 ng/ml (95% CI: 32.6–61.8%). We also noticed that the regional lymph node was the most common site with local recurrence compared with other sites (45.8%, 95% CI: 42.1–49.6%). Statistical heterogeneity and publication bias were found.Conclusion: The results suggest that 18F-DCFPyL PET/CT has a relatively high detection rate in BRPCa. The results also indicate that imaging with 18F-DCFPyL may exhibit improved sensitivity in BRPCa with increased PSA levels. Considering the publication bias, further large-scale multicenter studies are warranted for validation.

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