PET or PET/CT for detection of peritoneal carcinomatosis

A meta-analysis

Ming Che Chang, Jin Hua Chen, Ji An Liang, Wen Sheng Huang, Kai Yuan Cheng, Chia Hung Kao

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

The present study assessed the diagnostic performances of 18F-FDG PET or PET/CT in detecting peritoneal carcinomatosis in patients with cancer. METHODS: Through a search of MEDLINE (January 1998 to September 2012), an overall weighted average for sensitivity and specificity was calculated using the weighted averages of the sample sizes in each relevant study. Pooled estimates of positive and negative likelihood ratios were calculated using fixed and random effects models, respectively, according to the heterogeneity among studies. A summary receiver operating characteristics (sROC) curve was constructed and the area under the sROC curve (AUC) was calculated. To explore heterogeneity, due to sources other than threshold effects, I-square was calculated. RESULTS: The present study included analyses of patients (n = 513) from 7 studies. Results indicated a 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 peritoneal carcinomatosis were 72.4% (95% CI, 64.4%-79.5%) and 96.7% (95% CI, 94.4%-98.3%), respectively. The positive likelihood ratio was 10.414 (95% CI, 6.195-17.506) and the negative likelihood ratio 0.312 (95% CI, 0.159-0.612). The AUC was 0.9404. The overall diagnostic accuracy (Q* index) was 87.8%. CONCLUSION: The high specificity may provide the reliability of a positive FDG PET or PET/CT to detect peritoneal carcinomatosis in patients with cancer. FDG PET or PET/CT has only weak power to exclude the presence of peritoneal carcinomatosis. By a good overall diagnostic accuracy, FDG PET or PET/CT may prove beneficial to surgeons when selecting appropriate patients on whom to perform laparoscopy or laparotomy.

Original languageEnglish
Pages (from-to)623-629
Number of pages7
JournalClinical Nuclear Medicine
Volume38
Issue number8
DOIs
Publication statusPublished - Aug 2013
Externally publishedYes

Fingerprint

Meta-Analysis
Carcinoma
Sensitivity and Specificity
ROC Curve
Fluorodeoxyglucose F18
MEDLINE
Sample Size
Laparoscopy
Laparotomy
Area Under Curve
Neoplasms

Keywords

  • F-FDG
  • peritoneal carcinomatosis
  • peritoneal dissemination
  • PET
  • PET/CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

PET or PET/CT for detection of peritoneal carcinomatosis : A meta-analysis. / Chang, Ming Che; Chen, Jin Hua; Liang, Ji An; Huang, Wen Sheng; Cheng, Kai Yuan; Kao, Chia Hung.

In: Clinical Nuclear Medicine, Vol. 38, No. 8, 08.2013, p. 623-629.

Research output: Contribution to journalArticle

Chang, Ming Che ; Chen, Jin Hua ; Liang, Ji An ; Huang, Wen Sheng ; Cheng, Kai Yuan ; Kao, Chia Hung. / PET or PET/CT for detection of peritoneal carcinomatosis : A meta-analysis. In: Clinical Nuclear Medicine. 2013 ; Vol. 38, No. 8. pp. 623-629.
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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 peritoneal carcinomatosis in patients with cancer. METHODS: Through a search of MEDLINE (January 1998 to September 2012), an overall weighted average for sensitivity and specificity was calculated using the weighted averages of the sample sizes in each relevant study. Pooled estimates of positive and negative likelihood ratios were calculated using fixed and random effects models, respectively, according to the heterogeneity among studies. A summary receiver operating characteristics (sROC) curve was constructed and the area under the sROC curve (AUC) was calculated. To explore heterogeneity, due to sources other than threshold effects, I-square was calculated. RESULTS: The present study included analyses of patients (n = 513) from 7 studies. Results indicated a 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 peritoneal carcinomatosis were 72.4% (95% CI, 64.4%-79.5%) and 96.7% (95% CI, 94.4%-98.3%), respectively. The positive likelihood ratio was 10.414 (95% CI, 6.195-17.506) and the negative likelihood ratio 0.312 (95% CI, 0.159-0.612). The AUC was 0.9404. The overall diagnostic accuracy (Q* index) was 87.8%. CONCLUSION: The high specificity may provide the reliability of a positive FDG PET or PET/CT to detect peritoneal carcinomatosis in patients with cancer. FDG PET or PET/CT has only weak power to exclude the presence of peritoneal carcinomatosis. By a good overall diagnostic accuracy, FDG PET or PET/CT may prove beneficial to surgeons when selecting appropriate patients on whom to perform laparoscopy or laparotomy.

AB - The present study assessed the diagnostic performances of 18F-FDG PET or PET/CT in detecting peritoneal carcinomatosis in patients with cancer. METHODS: Through a search of MEDLINE (January 1998 to September 2012), an overall weighted average for sensitivity and specificity was calculated using the weighted averages of the sample sizes in each relevant study. Pooled estimates of positive and negative likelihood ratios were calculated using fixed and random effects models, respectively, according to the heterogeneity among studies. A summary receiver operating characteristics (sROC) curve was constructed and the area under the sROC curve (AUC) was calculated. To explore heterogeneity, due to sources other than threshold effects, I-square was calculated. RESULTS: The present study included analyses of patients (n = 513) from 7 studies. Results indicated a 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 peritoneal carcinomatosis were 72.4% (95% CI, 64.4%-79.5%) and 96.7% (95% CI, 94.4%-98.3%), respectively. The positive likelihood ratio was 10.414 (95% CI, 6.195-17.506) and the negative likelihood ratio 0.312 (95% CI, 0.159-0.612). The AUC was 0.9404. The overall diagnostic accuracy (Q* index) was 87.8%. CONCLUSION: The high specificity may provide the reliability of a positive FDG PET or PET/CT to detect peritoneal carcinomatosis in patients with cancer. FDG PET or PET/CT has only weak power to exclude the presence of peritoneal carcinomatosis. By a good overall diagnostic accuracy, FDG PET or PET/CT may prove beneficial to surgeons when selecting appropriate patients on whom to perform laparoscopy or laparotomy.

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