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Diagnostic role of F-18 FDG PET/CT in determining preoperative Lymph node status of patients with rectal cancer: a meta-analysis

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Abstract

Purpose

To obtain performance values of PET/CT for determining the nodal status of rectal cancer.

Materials

A comprehensive literature search was performed on PubMed and Embase for original diagnostic accuracy studies on the diagnostic performance of PET-CT for detection of LN metastasis in rectal cancer. The QUADAS-2 was used to evaluate the methodological quality of each study. Pooled sensitivity, specificity, and AUC were calculated to estimate the diagnostic role of PET/CT using a random-effects model. A subgroup analysis was performed to investigate the influence of different parameters on diagnostic performance.

Results

A total of 15 studies and 1209 patients were included. A publication bias was observed. The pooled sensitivity, specificity, and AUC for PET/CT was 0.62 (95% CI 0.49, 0.74), 0.94 (95% CI 0.87, 0.97), and 0.87 (95% CI 0.83–0.89), respectively. Per-node basis yields higher accuracy than per-patient basis, with pooled sensitivities of 0.65 (95% CI 0.50–0.79) vs. 0.56 (95% CI 0.36–0.77) and specificities of 0.96 (95% CI 0.92–1.00) vs. 0.88 (95% CI 0.76–1.00), but there were no significant differences in diagnostic accuracy.

Conclusion

PET/CT has high specificity but moderate sensitivity for the detection of LN metastasis in rectal cancer. The current data suggests that the diagnostic capabilities of this method is limited due to its moderate sensitivity.

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Abbreviations

LN:

Lymph node

MRI:

Magnetic resonance imaging

CT:

Computed tomography

EUS:

Endoscopic ultrasonography

TP:

True positives

TN:

True negatives

FN:

False negatives

FP:

False positives

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Funding

This work was supported by Medical and Health Science and Technology Plan Project of Zhejiang Province (Grant Number: 2022KY1296). The funding departments had no role in the collection, analysis, or interpretation of the data, or in the decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Radiology, Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, Shaoxing People’s Hospital, Shaoxing, 312000, China

    Weili Ma, Bo Chen, Fandong Zhu, Chen Yang & Jianfeng Yang

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  1. Weili Ma
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  2. Bo Chen
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Correspondence to Jianfeng Yang.

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Ma, W., Chen, B., Zhu, F. et al. Diagnostic role of F-18 FDG PET/CT in determining preoperative Lymph node status of patients with rectal cancer: a meta-analysis. Abdom Radiol (2024). https://doi.org/10.1007/s00261-023-04140-4

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  • DOI: https://doi.org/10.1007/s00261-023-04140-4

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