18F-FDG PET or PET/CT for detection of metastatic lymph nodes in patients with endometrial cancer: A systematic review and meta-analysis

Ming Che Chang, Jin Hua Chen, Ji An Liang, Kuang Tao Yang, Kai Yuan Cheng, Chia Hung Kao

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

The present study assessed the diagnostic performances of 18F-FDG PET or PET/CT in detecting pelvic and/or paraaortic lymph node metastasis in patients with endometrial cancer. Methods: Through a search of MEDLINE (January 1998 to March 2011), an overall weighted average for sensitivity and specificity as well as pooled estimates of positive and negative likelihood ratios were calculated. A summary receiver-operating-characteristics (sROC) curve was constructed and the area under the sROC curve (AUC) was calculated. I-square was calculated to explore heterogeneity. Results: The present study included 243 patients from seven studies. Results indicated a lack of significant heterogeneity for sensitivity and specificity (I2 <50% and p > 0.05). The overall pooled estimates for sensitivity and specificity of FDG-PET or PET/CT scans in the detection of pelvic and/or paraaortic metastasis were 63.0% (95% CI, 48.7-75.7%) and 94.7% (95% CI, 90.4-97.4%), respectively. The positive likelihood ratio was 10.465 (95% CI, 5.646-19.396) and the negative likelihood ratio 0.399 (95% CI, 0.284-0.560). The AUC was 0.9533. The overall diagnostic accuracy (Q* index) was 89.5%. Conclusion The high positive likelihood value confirms the reliability of a positive FDG-PET or PET/CT to detect pelvic and/or paraaortic lymph nodes metastasis in patients with untreated endometrial cancer. FDG-PET or PET/CT may prove beneficial to surgeons when selecting appropriate patients on whom to perform lymphadenectomy.

Original languageEnglish
Pages (from-to)3511-3517
Number of pages7
JournalEuropean Journal of Radiology
Volume81
Issue number11
DOIs
Publication statusPublished - Nov 2012
Externally publishedYes

Fingerprint

Fluorodeoxyglucose F18
Endometrial Neoplasms
Meta-Analysis
Lymph Nodes
Neoplasm Metastasis
Sensitivity and Specificity
ROC Curve
Lymph Node Excision
MEDLINE
Area Under Curve

Keywords

  • 18F-FDG
  • Endometrial cancer
  • Lymph node staging
  • PET
  • PET/CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

18F-FDG PET or PET/CT for detection of metastatic lymph nodes in patients with endometrial cancer : A systematic review and meta-analysis. / Chang, Ming Che; Chen, Jin Hua; Liang, Ji An; Yang, Kuang Tao; Cheng, Kai Yuan; Kao, Chia Hung.

In: European Journal of Radiology, Vol. 81, No. 11, 11.2012, p. 3511-3517.

Research output: Contribution to journalArticle

Chang, Ming Che ; Chen, Jin Hua ; Liang, Ji An ; Yang, Kuang Tao ; Cheng, Kai Yuan ; Kao, Chia Hung. / 18F-FDG PET or PET/CT for detection of metastatic lymph nodes in patients with endometrial cancer : A systematic review and meta-analysis. In: European Journal of Radiology. 2012 ; Vol. 81, No. 11. pp. 3511-3517.
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abstract = "The present study assessed the diagnostic performances of 18F-FDG PET or PET/CT in detecting pelvic and/or paraaortic lymph node metastasis in patients with endometrial cancer. Methods: Through a search of MEDLINE (January 1998 to March 2011), an overall weighted average for sensitivity and specificity as well as pooled estimates of positive and negative likelihood ratios were calculated. A summary receiver-operating-characteristics (sROC) curve was constructed and the area under the sROC curve (AUC) was calculated. I-square was calculated to explore heterogeneity. Results: The present study included 243 patients from seven studies. Results indicated a lack of significant heterogeneity for sensitivity and specificity (I2 <50{\%} and p > 0.05). The overall pooled estimates for sensitivity and specificity of FDG-PET or PET/CT scans in the detection of pelvic and/or paraaortic metastasis were 63.0{\%} (95{\%} CI, 48.7-75.7{\%}) and 94.7{\%} (95{\%} CI, 90.4-97.4{\%}), respectively. The positive likelihood ratio was 10.465 (95{\%} CI, 5.646-19.396) and the negative likelihood ratio 0.399 (95{\%} CI, 0.284-0.560). The AUC was 0.9533. The overall diagnostic accuracy (Q* index) was 89.5{\%}. Conclusion The high positive likelihood value confirms the reliability of a positive FDG-PET or PET/CT to detect pelvic and/or paraaortic lymph nodes metastasis in patients with untreated endometrial cancer. FDG-PET or PET/CT may prove beneficial to surgeons when selecting appropriate patients on whom to perform lymphadenectomy.",
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AU - Yang, Kuang Tao

AU - Cheng, Kai Yuan

AU - Kao, Chia Hung

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N2 - The present study assessed the diagnostic performances of 18F-FDG PET or PET/CT in detecting pelvic and/or paraaortic lymph node metastasis in patients with endometrial cancer. Methods: Through a search of MEDLINE (January 1998 to March 2011), an overall weighted average for sensitivity and specificity as well as pooled estimates of positive and negative likelihood ratios were calculated. A summary receiver-operating-characteristics (sROC) curve was constructed and the area under the sROC curve (AUC) was calculated. I-square was calculated to explore heterogeneity. Results: The present study included 243 patients from seven studies. Results indicated a lack of significant heterogeneity for sensitivity and specificity (I2 <50% and p > 0.05). The overall pooled estimates for sensitivity and specificity of FDG-PET or PET/CT scans in the detection of pelvic and/or paraaortic metastasis were 63.0% (95% CI, 48.7-75.7%) and 94.7% (95% CI, 90.4-97.4%), respectively. The positive likelihood ratio was 10.465 (95% CI, 5.646-19.396) and the negative likelihood ratio 0.399 (95% CI, 0.284-0.560). The AUC was 0.9533. The overall diagnostic accuracy (Q* index) was 89.5%. Conclusion The high positive likelihood value confirms the reliability of a positive FDG-PET or PET/CT to detect pelvic and/or paraaortic lymph nodes metastasis in patients with untreated endometrial cancer. FDG-PET or PET/CT may prove beneficial to surgeons when selecting appropriate patients on whom to perform lymphadenectomy.

AB - The present study assessed the diagnostic performances of 18F-FDG PET or PET/CT in detecting pelvic and/or paraaortic lymph node metastasis in patients with endometrial cancer. Methods: Through a search of MEDLINE (January 1998 to March 2011), an overall weighted average for sensitivity and specificity as well as pooled estimates of positive and negative likelihood ratios were calculated. A summary receiver-operating-characteristics (sROC) curve was constructed and the area under the sROC curve (AUC) was calculated. I-square was calculated to explore heterogeneity. Results: The present study included 243 patients from seven studies. Results indicated a lack of significant heterogeneity for sensitivity and specificity (I2 <50% and p > 0.05). The overall pooled estimates for sensitivity and specificity of FDG-PET or PET/CT scans in the detection of pelvic and/or paraaortic metastasis were 63.0% (95% CI, 48.7-75.7%) and 94.7% (95% CI, 90.4-97.4%), respectively. The positive likelihood ratio was 10.465 (95% CI, 5.646-19.396) and the negative likelihood ratio 0.399 (95% CI, 0.284-0.560). The AUC was 0.9533. The overall diagnostic accuracy (Q* index) was 89.5%. Conclusion The high positive likelihood value confirms the reliability of a positive FDG-PET or PET/CT to detect pelvic and/or paraaortic lymph nodes metastasis in patients with untreated endometrial cancer. FDG-PET or PET/CT may prove beneficial to surgeons when selecting appropriate patients on whom to perform lymphadenectomy.

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