Performance of Whole-Body PET/CT for the Detection of Distant Malignancies in Various Cancers: A Systematic Review and Meta-Analysis

Evidence-Based Medical Center, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.
Journal of Nuclear Medicine (Impact Factor: 6.16). 10/2012; 53(12). DOI: 10.2967/jnumed.112.105049
Source: PubMed


At present, there is no ideal imaging modality for the diagnosis of distant metastases and second primary cancers in cancer patients. We aimed to assess the accuracy of whole-body PET/CT for the overall assessment of distant malignancies in patients with various cancers.

Studies about whole-body PET/CT for the detection of distant malignancies in cancer patients were systematically searched in MEDLINE and EMBASE. We determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios, and constructed summary receiver operating characteristic curves using hierarchical regression models for whole-body PET/CT.

Across 41 studies (4,305 patients), the sensitivity and specificity of whole-body PET/CT were 0.93 (95% confidence interval [CI], 0.88-0.96) and 0.96 (95% CI, 0.95-0.96), respectively. Subgroup analysis showed that the sensitivity and specificity of whole-body PET/CT for various cancers, respectively, were as follows: head and neck cancer, 0.90 (95% CI, 0.83-0.95) and 0.95 (95% CI, 0.94-0.96); lung cancer, 0.91 (95% CI, 0.76-0.97) and 0.96 (95% CI, 0.94-0.98); breast cancer, 0.97 (95% CI, 0.93-0.99) and 0.95 (95% CI, 0.90-0.97); and cancer of digestive system, 0.92 (95% CI, 0.68-0.98) and 0.97 (95% CI, 0.91-0.99).

Whole-body PET/CT has excellent diagnostic performance for the overall assessment of distant malignancies in patients with various cancers, especially head and neck cancer, breast cancer, and lung cancer.

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    • "A recent meta-analysis determined the accuracy of 18F-FDG PET/CT for detecting distant metastases or synchronous second cancers in more than 4,300 patients. On the basis of prospectively defined criteria, 41 published studies including patients with primary (n = 21 studies) or recurrent (n = 14 studies) cancers and patients with primary and recurrent cancers (n = 6) were included [114]. In addition, the diagnostic performance of PET/CT was compared with that of conventional imaging in more than 800 patients. "
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