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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

For N classification: (A) Pooled sensitivity (B) Pooled specificity (C) Pooled diagnostic odds ratio (D) Summary receiver operating characteristic (SROC) curve with Q*-index.
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f3-rado-48-04-331: For N classification: (A) Pooled sensitivity (B) Pooled specificity (C) Pooled diagnostic odds ratio (D) Summary receiver operating characteristic (SROC) curve with Q*-index.

Mentions: N classification. The combined sensitivity estimate for N classification is 0.84 (95% CI 0.76–0.91) and specificity 0.90 (95% CI 0.83–0.97). The pooled DOR for N classification was 82.4 (23.2–292.6). The Q*-index was 0.90 (SE 0.03) (Figure 3). The reference standards used for N classification varied amongst studies. MRI neck was the most frequently used reference standard.11,24,26,27 Two studies relied on clinical follow up to be their reference standard,23,25 and 2 other studies required histological confirmation though fine needle aspiration of involved cervical nodes.10,20 One study used contrast enhanced CT to be their reference standard19, which is considered to be inferior to MRI.29,30


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)

For N classification: (A) Pooled sensitivity (B) Pooled specificity (C) Pooled diagnostic odds ratio (D) Summary receiver operating characteristic (SROC) curve with Q*-index.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f3-rado-48-04-331: For N classification: (A) Pooled sensitivity (B) Pooled specificity (C) Pooled diagnostic odds ratio (D) Summary receiver operating characteristic (SROC) curve with Q*-index.
Mentions: N classification. The combined sensitivity estimate for N classification is 0.84 (95% CI 0.76–0.91) and specificity 0.90 (95% CI 0.83–0.97). The pooled DOR for N classification was 82.4 (23.2–292.6). The Q*-index was 0.90 (SE 0.03) (Figure 3). The reference standards used for N classification varied amongst studies. MRI neck was the most frequently used reference standard.11,24,26,27 Two studies relied on clinical follow up to be their reference standard,23,25 and 2 other studies required histological confirmation though fine needle aspiration of involved cervical nodes.10,20 One study used contrast enhanced CT to be their reference standard19, which is considered to be inferior to MRI.29,30

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