Diagnostic Performance of Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography in Patients with Merkel Cell Carcinoma: A Systematic Review and Meta-Analysis
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Some studies reported the usefulness of fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and PET/computed tomography (CT) in patients with Merkel cell carcinoma (MCC).
The aim of this study was to systematically review and meta-analyze published data about the diagnostic performance of 18F-FDG PET and PET/CT in patients with MCC.
A comprehensive literature search of studies published through June 2013 regarding 18F-FDG PET and PET/CT in patients with MCC was performed. All retrieved studies were reviewed and qualitatively analyzed. Pooled sensitivity, specificity, positive and negative likelihood ratio (LR+ and LR−) and diagnostic odds ratio (DOR) of 18F-FDG PET or PET/CT in patients with MCC on a per examination-based analysis were calculated. The area under the summary receiver operating characteristic (ROC) curve was calculated to measure the accuracy of 18F-FDG PET or PET/CT in these patients.
Ten studies comprising 329 patients (549 scans) with MCC were included in the qualitative analysis (systematic review) and discussed. The quantitative analysis (meta-analysis) of six selected studies (including 92 patients with MCC) provided the following results on a per examination-based analysis: sensitivity was 90 % (95 % CI 80–96), specificity 98 % (95 % CI 90–100), LR+ 12 (95 % CI 4.3–33.0), LR− 0.15 (95 % CI 0.08–0.28), and DOR 86.8 (95 % CI 23–327). The area under the summary ROC curve was 0.96. No significant statistical heterogeneity between the studies was found.
In patients with MCC, 18F-FDG PET or PET/CT demonstrated high sensitivity and specificity, being accurate methods in this setting. Nevertheless, the literature focusing on the use of PET and PET/CT in MCC still remains limited. Prospective studies are needed to substantiate the high diagnostic accuracy of these methods in MCC.
The authors have received no funding and declare that they have no conflicts of interest.
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