Diagnostic value of 18F-fluorodeoxyglucose positron-emission tomography/computed tomography for preoperative lymph node metastasis of esophageal cancer: A meta-analysis

Medicine (Baltimore). 2018 Dec;97(50):e13722. doi: 10.1097/MD.0000000000013722.

Abstract

Objective: We determined the value of F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) for the assessment of preoperative lymph node metastases in patients with esophageal cancer.

Methods: We searched electronic database indexes for articles on PET/CT assessment of lymph node status. Information including true positives, false positives, false negatives, and true negatives was obtained. Based on these data, the pooled sensitivity, specificity, diagnostic odds ratio, and likelihood ratio were calculated using bivariate models and receiver operating characteristic curves (ROCs) were drawn.

Results: Patients without neoadjuvant treatment had a pooled sensitivity and specificity (95% confidence interval [CI]) of 0.57 (0.45-0.69) and 0.91 (0.85-0.95), respectively. Patients who received neoadjuvant treatment had a pooled sensitivity and specificity of 0.53 (0.35-0.70) and 0.96 (0.86-0.99), respectively.

Conclusions: The PET/CT has a high diagnostic specificity but its diagnostic sensitivity is low; thus, its diagnosis findings cannot accurately reflect the lymph node status.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Esophageal Neoplasms / pathology*
  • Esophageal Neoplasms / secondary
  • Esophageal Neoplasms / therapy
  • Female
  • Fluorodeoxyglucose F18 / administration & dosage
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Lymphatic Metastasis / diagnostic imaging*
  • Lymphatic Metastasis / pathology
  • Male
  • Neoadjuvant Therapy
  • Positron Emission Tomography Computed Tomography / methods*
  • Preoperative Care / methods
  • Prognosis
  • Radiopharmaceuticals / administration & dosage
  • Retrospective Studies

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18