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KMID : 1137020180290060098
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Journal of Gynecologic Oncology
2018 Volume.29 No. 6 p.98 ~ p.98
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Performance of pre-treatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography for detecting metastasis in ovarian cancer: a systematic review and meta-analysis
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Han Sang-Won
Woo Sung-Min
Suh Chong-Hyun
Lee Jong-Jin
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Abstract
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Objective: We describe a systematic review and meta-analysis of the performance of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting metastasis in ovarian cancer.
Methods: MEDLINE and Embase were searched for diagnostic accuracy studies that used 18F-FDG PET or PET/CT for pre-treatment staging, using surgical findings as the reference standard. Sensitivities and specificities were pooled and plotted in a hierarchic summary receiver operating characteristic plot. Potential causes of heterogeneity were explored through sensitivity analyses.
Results: Eight studies with 594 patients were included. The overall pooled sensitivity and specificity for metastasis were 0.72 (95% confidence interval [CI]=0.61?0.81) and 0.93 (95% CI=0.85?0.97), respectively. There was considerable heterogeneity in sensitivity (I2=97.57%) and specificity (I2=96.74%). In sensitivity analyses, studies that used laparotomy as the reference standard showed significantly higher sensitivity and specificity (0.77; 95% CI=0.67?0.87 and 0.96; 95% CI=0.92?0.99, respectively) than those including diagnostic laparoscopy (0.62; 95% CI=0.46?0.77 and 0.84; 95% CI=0.69?0.99, respectively). Higher specificity was shown in studies that confirmed surgical findings by pathologic evaluation (0.95; 95% CI=0.90?0.99) than in a study without pathologic confirmation (0.69; 95% CI=0.24?1.00). Studies with a lower prevalence of the FDG-avid subtype showed higher specificity (0.97; 95% CI=0.94?1.00) than those with a greater prevalence (0.89; 95% CI=0.80?0.97).
Conclusion: Pre-treatment 18F-FDG PET/CT shows moderate sensitivity and high specificity for detecting metastasis in ovarian cancer. With its low false-positive rate, it can help select surgical approaches or alternative treatment options.
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KEYWORD
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PET Scan, Ovarian Neoplasms, Neoplasm Metastasis, Sensitivity and Specificity, Meta-Analysis
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