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Erschienen in:
16.06.2022 | Review Article
Diagnostic performance of [18F]-FDG PET/MR in evaluating colorectal cancer: a systematic review and meta-analysis
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 12/2022
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Purpose
To calculate the diagnostic performance of [18F]-FDG PET/MR in colorectal cancer (CRC).
Methods
This study was designed following the PRISMA-DTA guidelines. To be included, published original articles (until December 31, 2021) that met the following criteria were considered eligible: (1) evaluated [18F]-FDG PET/MR as the diagnostic method to detect CRC; (2) compared [18F]-FDG PET/MR with histopathology as the reference standard, or clinical/imaging composite follow-up when pathology was not available; (3) provided adequate crude data for meta-analysis. The diagnostic pooled measurements were calculated at patient and lesion levels. Regarding sub-group analysis, diagnostic measurements were calculated in “TNM staging,” “T staging,” “N staging,” “M staging,” and “liver metastasis” sub-groups. Additionally, we calculated the pooled performances in “rectal cancer: patient-level” and “rectal cancer: lesion-level” sub-groups. A hierarchical method was used to pool the performances. The bivariate model was conducted to find the summary points. Analyses were performed using STATA 16.
Results
A total of 1534 patients from 18 studies were entered. The pooled sensitivities in CRC lesion detection (tumor, lymph nodes, and metastases) were 0.94 (95%CI: 0.89–0.97) and 0.93 (95%CI: 0.82–0.98) at patient-level and lesion-level, respectively. The pooled specificities were 0.89 (95%CI: 0.84–0.93) and 0.95 (95%CI: 0.90–0.98) at patient-level and lesion-level, respectively. In sub-groups, the highest sensitivity (0.97, 95%CI: 0.86–0.99) and specificity (0.99, 95%CI: 0.84–1.00) were calculated for “M staging” and “rectal cancer: lesion-level,” respectively. The lowest sensitivity (0.81, 95%CI: 0.65–0.91) and specificity (0.79, 95%CI: 0.52–0.93) were calculated for “N staging” and “T staging,” respectively.
Conclusion
This meta-analysis showed an overall high diagnostic performance for [18F]-FDG PET/MR in detecting CRC lesions/metastases. Thus, this modality can play a significant role in several clinical scenarios in CRC staging and restaging. Specifically, one of the main strengths of this modality is ruling out the existence of CRC lesions/metastases. Finally, the overall diagnostic performance was not found to be affected in the post-treatment setting.