18FDG PET-CT for distant metastases in patients with recurrent head and neck cancer after definitive treatment. A meta-analysis.

To evaluate the role of 18FDG PET-CT for screening distant metastases before salvage treatment in patients with suspected recurrent head and neck cancer. Studies about 18FDG PET-CT were systematically searched in the MEDLINE and EMBASE databases (last update October 05, 2013). We calculated sensitivities, specificities, positive likelihood ratios and negative likelihood ratios, and constructed summary receiver operating characteristic curves for 18FDG PET-CT. Ten PET-CT studies (756 patients and 797 imaging examinations) were identified. The sensitivity, specificity, positive likelihood ratio and negative likelihood ratio for 18FDG PET-CT were 0.92 (95% CI=0.83-0.96), 0.95 (95% CI=0.91-0.97), 16.7 (95% CI=9.9-28.4), and 0.09 (95% CI=0.04-0.18), respectively. Overall weighted area under the curve was 0.97 (95% CI=0.96-0.98). 18FDG PET-CT has high sensitivity and accuracy for screening distant metastases before salvage treatment in patients with suspected recurrent head and neck cancer.