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Accuracy of (18)F-flurodeoxyglucose-positron emission tomography/computed tomography in the staging of newly diagnosed nasopharyngeal carcinoma: a systematic review and meta-analysis.

Vellayappan BA, Soon YY, Earnest A, Zhang Q, Koh WY, Tham IW, Lee KM - Radiol Oncol (2014)

Bottom Line: Five addressed primary tumor (T), nine addressed regional lymph nodes (N) and seven addressed distant metastasis (M).For N classification, combined sensitivity was 0.84 (95% CI 0.76-0.91), specificity was 0.90 (95% CI 0.83-0.97), DOR was 82.4 (23.2-292.6) and Q*-index was 0.90.For M classification, the combined sensitivity estimate was 0.87 (95% CI 0.74-1.00), specificity was 0.98 (95% CI 0.96-1.00), DOR was 120.9 (43.0-340.0) and Q*-index was 0.89.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, National University Cancer Institute, National University Health System, National University of Singapore, Singapore.

ABSTRACT

Background: The specific role of 18F-flurodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in staging of nasopharyngeal carcinoma (NPC) remains to be validated. A systematic review and meta-analysis were performed to assess the accuracy of staging FDG-PET/CT for newly diagnosed NPC.

Methods: We searched various biomedical databases and conference proceedings for relevant studies. We determined the pooled sensitivities and specificities, diagnostic odds ratios (DOR) and constructed summary receiver operating characteristic (SROC) curves using the hierarchical regression model.

Results: 15 relevant studies including 851 patients were identified. Five addressed primary tumor (T), nine addressed regional lymph nodes (N) and seven addressed distant metastasis (M). The combined sensitivity estimate for FDG-PET/CT in T classification was 0.77 (95% confidence interval [CI] 0.59-0.95). For N classification, combined sensitivity was 0.84 (95% CI 0.76-0.91), specificity was 0.90 (95% CI 0.83-0.97), DOR was 82.4 (23.2-292.6) and Q*-index was 0.90. For M classification, the combined sensitivity estimate was 0.87 (95% CI 0.74-1.00), specificity was 0.98 (95% CI 0.96-1.00), DOR was 120.9 (43.0-340.0) and Q*-index was 0.89.

Conclusion: FDG-PET/CT showed good accuracy in N and M but not T classification for newly diagnosed NPC. FDG-PET/CT, together with Magnetic resonance imaging (MRI) of the nasopharynx, should be part of the routine staging investigations.

No MeSH data available.


Related in: MedlinePlus

Pooled sensitivity for T classification.
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f2-rado-48-04-331: Pooled sensitivity for T classification.

Mentions: T classification. Based on the combined data from five available studies that evaluated the T-classification our analysis revealed a sensitivity of 0.77(95% CI 0.59–0.95) while no specificity level could be ascertained (Figure 2). Four (of the five) studies did not report false positive results hence preventing us from calculating the specificity for T classification.19–22 Subgroup analysis revealed the sensitivity of FDG-PET/CT was lower when compared to MRI alone; however, this was not statistically significant (0.65 vs. 0.86, P=0.214). The sensitivity results on T classification were similar with exclusion of the two low quality studies,19,21 or the two retrospective studies.11,19


Accuracy of (18)F-flurodeoxyglucose-positron emission tomography/computed tomography in the staging of newly diagnosed nasopharyngeal carcinoma: a systematic review and meta-analysis.

Vellayappan BA, Soon YY, Earnest A, Zhang Q, Koh WY, Tham IW, Lee KM - Radiol Oncol (2014)

Pooled sensitivity for T classification.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230552&req=5

f2-rado-48-04-331: Pooled sensitivity for T classification.
Mentions: T classification. Based on the combined data from five available studies that evaluated the T-classification our analysis revealed a sensitivity of 0.77(95% CI 0.59–0.95) while no specificity level could be ascertained (Figure 2). Four (of the five) studies did not report false positive results hence preventing us from calculating the specificity for T classification.19–22 Subgroup analysis revealed the sensitivity of FDG-PET/CT was lower when compared to MRI alone; however, this was not statistically significant (0.65 vs. 0.86, P=0.214). The sensitivity results on T classification were similar with exclusion of the two low quality studies,19,21 or the two retrospective studies.11,19

Bottom Line: Five addressed primary tumor (T), nine addressed regional lymph nodes (N) and seven addressed distant metastasis (M).For N classification, combined sensitivity was 0.84 (95% CI 0.76-0.91), specificity was 0.90 (95% CI 0.83-0.97), DOR was 82.4 (23.2-292.6) and Q*-index was 0.90.For M classification, the combined sensitivity estimate was 0.87 (95% CI 0.74-1.00), specificity was 0.98 (95% CI 0.96-1.00), DOR was 120.9 (43.0-340.0) and Q*-index was 0.89.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, National University Cancer Institute, National University Health System, National University of Singapore, Singapore.

ABSTRACT

Background: The specific role of 18F-flurodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in staging of nasopharyngeal carcinoma (NPC) remains to be validated. A systematic review and meta-analysis were performed to assess the accuracy of staging FDG-PET/CT for newly diagnosed NPC.

Methods: We searched various biomedical databases and conference proceedings for relevant studies. We determined the pooled sensitivities and specificities, diagnostic odds ratios (DOR) and constructed summary receiver operating characteristic (SROC) curves using the hierarchical regression model.

Results: 15 relevant studies including 851 patients were identified. Five addressed primary tumor (T), nine addressed regional lymph nodes (N) and seven addressed distant metastasis (M). The combined sensitivity estimate for FDG-PET/CT in T classification was 0.77 (95% confidence interval [CI] 0.59-0.95). For N classification, combined sensitivity was 0.84 (95% CI 0.76-0.91), specificity was 0.90 (95% CI 0.83-0.97), DOR was 82.4 (23.2-292.6) and Q*-index was 0.90. For M classification, the combined sensitivity estimate was 0.87 (95% CI 0.74-1.00), specificity was 0.98 (95% CI 0.96-1.00), DOR was 120.9 (43.0-340.0) and Q*-index was 0.89.

Conclusion: FDG-PET/CT showed good accuracy in N and M but not T classification for newly diagnosed NPC. FDG-PET/CT, together with Magnetic resonance imaging (MRI) of the nasopharynx, should be part of the routine staging investigations.

No MeSH data available.


Related in: MedlinePlus