UNLABELLED: We assessed the diagnostic performance of (18)F-FDG PET in detecting paraaortic lymph node (PALN) metastasis in patients with cervical cancer. METHODS: Through a search of MEDLINE and EMBASE (1980 to March 2009), we performed a random-effects meta analysis. A summary receiver-operating-characteristic curve was constructed using hierarchical regression models. To identify other sources of heterogeneity, regression meta analysis was performed. RESULTS: Patients (n = 385) from 10 studies were analyzed. Although specificity of (18)F-FDG PET was consistent (97%; 95% confidence interval [CI], 93%-99%), sensitivity was low and heterogeneous among the studies (34%; 95% CI, 10%-72%). Although regression meta analysis did not identify any source to which heterogeneity could be attributed, it revealed a trend of increasing sensitivity according to an increase in the prevalence of PALN metastasis (P = 0.001). In the 5 studies with prevalence greater than 15%, estimated sensitivity and specificity were 73% (95% CI, 53%-87%) and 93% (95% CI, 86%-97%), respectively. With the diagnostic performance, assuming the prevalence of 15%, the calculated false-positive and -negative rates were 35% and 5%, respectively. CONCLUSION: In detecting PALN metastasis, PET performs acceptably only in populations with a relatively high probability of PALN metastasis. Otherwise, we found no evidence to justify the evaluation of PALN based solely on PET in cervical cancer.
UNLABELLED: We assessed the diagnostic performance of (18)F-FDG PET in detecting paraaortic lymph node (PALN) metastasis in patients with cervical cancer. METHODS: Through a search of MEDLINE and EMBASE (1980 to March 2009), we performed a random-effects meta analysis. A summary receiver-operating-characteristic curve was constructed using hierarchical regression models. To identify other sources of heterogeneity, regression meta analysis was performed. RESULTS:Patients (n = 385) from 10 studies were analyzed. Although specificity of (18)F-FDG PET was consistent (97%; 95% confidence interval [CI], 93%-99%), sensitivity was low and heterogeneous among the studies (34%; 95% CI, 10%-72%). Although regression meta analysis did not identify any source to which heterogeneity could be attributed, it revealed a trend of increasing sensitivity according to an increase in the prevalence of PALN metastasis (P = 0.001). In the 5 studies with prevalence greater than 15%, estimated sensitivity and specificity were 73% (95% CI, 53%-87%) and 93% (95% CI, 86%-97%), respectively. With the diagnostic performance, assuming the prevalence of 15%, the calculated false-positive and -negative rates were 35% and 5%, respectively. CONCLUSION: In detecting PALN metastasis, PET performs acceptably only in populations with a relatively high probability of PALN metastasis. Otherwise, we found no evidence to justify the evaluation of PALN based solely on PET in cervical cancer.
Authors: Matthias W Beckmann; Frederik A Stübs; Martin C Koch; Peter Mallmann; Christian Dannecker; Anna Dietl; Anna Sevnina; Franziska Mergel; Laura Lotz; Carolin C Hack; Anne Ehret; Daniel Gantert; Franca Martignoni; Jan-Philipp Cieslik; Jan Menke; Olaf Ortmann; Carmen Stromberger; Karin Oechsle; Beate Hornemann; Friederike Mumm; Christoph Grimm; Alina Sturdza; Edward Wight; Kristina Loessl; Michael Golatta; Volker Hagen; Timm Dauelsberg; Ingo Diel; Karsten Münstedt; Eberhard Merz; Dirk Vordermark; Katja Lindel; Christian Wittekind; Volkmar Küppers; Ralph Lellé; Klaus Neis; Henrik Griesser; Birgit Pöschel; Manfred Steiner; Ulrich Freitag; Tobias Gilster; Alexander Schmittel; Michael Friedrich; Heidemarie Haase; Marion Gebhardt; Ludwig Kiesel; Michael Reinhardt; Michael Kreißl; Marianne Kloke; Lars-Christian Horn; Regina Wiedemann; Simone Marnitz; Anne Letsch; Isabella Zraik; Bernhard Mangold; Jochen Möckel; Céline Alt; Pauline Wimberger; Peter Hillemanns; Kerstin Paradies; Alexander Mustea; Dominik Denschlag; Ulla Henscher; Reina Tholen; Simone Wesselmann; Tanja Fehm Journal: Geburtshilfe Frauenheilkd Date: 2022-02-11 Impact factor: 2.915