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Diagnostic performance of 18F-FDG PET or PET/CT in differential diagnosis of uterine leiomyomas and uterine sarcomas: systematic review and meta-analysis of the literature

Abstract

Objective

The radiological features of uterine mesenchymal tumors are sometimes similar, which makes differential diagnosis difficult. The aim of meta-analysis was to provide an overview of the literature on the diagnostic performance of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) or PET/computed tomography (CT) in differentiating between uterine leiomyomas and uterine sarcomas.

Methods

A systematic search of the MEDLINE and EMBASE databases up to June 1, 2021, was performed. All studies that reported the diagnostic accuracy of 18F-FDG PET or PET/CT in differentiating between uterine leiomyomas and uterine sarcomas were considered eligible. Histological confirmation of surgical specimens or clinical confirmation by long-term follow-up examination was considered as the reference standard. Data on diagnostic accuracy were extracted or calculated and presented as forest plots. A bivariate random-effects model was used to calculate pooled estimates of sensitivity and specificity.

Results

A total of seven studies with 196 patients were included for data extraction among initial 507 studies. The overall pooled estimates for sensitivity and specificity were 0.88 [95% confidence interval (CI) = 0.77–0.94] and 0.83 (95% CI = 0.76–0.89), respectively. Likelihood ratio (LR) syntheses yielded an overall positive LR of 4.24 (95% CI = 3.0–6.01) and negative LR of 0.22 (95% CI = 0.13–0.37). The pooled diagnostic odds ratio was 29.59 (95% CI = 12.42–70.49). The area under the hierarchical summary receiver operating characteristic curve was 0.87.

Conclusion

This meta-analysis showed that 18F-FDG PET/CT is a good imaging modality for differentiating between uterine leiomyomas and uterine sarcomas.

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Correspondence to Seo Young Kang.

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Ji-In Bang and Seo Young Kang declare no potential conflicts of interests.

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This manuscript has not been published elsewhere and is not under consideration by another journal. The study protocol was registered to the International Prospective Register of Systematic Reviews (registration No. CRD42021258208).

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Bang, JI., Kang, S.Y. Diagnostic performance of 18F-FDG PET or PET/CT in differential diagnosis of uterine leiomyomas and uterine sarcomas: systematic review and meta-analysis of the literature. Clin Transl Imaging 10, 301–309 (2022). https://doi.org/10.1007/s40336-022-00488-7

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  • DOI: https://doi.org/10.1007/s40336-022-00488-7

Keywords

  • Fluorodeoxyglucose F18
  • Positron emission computed tomography
  • Leiomyoma
  • Sarcomas
  • Uterus
  • Meta-analysis