Seong-Jang Kim1,2,3, Sang Woo Lee4. 1. 1Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan, 50612, Korea. 2. 2BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, 50612, Korea. 3. 3Department of Nuclear Medicine, College of Medicine, Pusan National University, Yangsan, 50612, Korea. 4. 4Department of Nuclear Medicine, Kyungpook National University Medical Center and School of Medicine, Daegu, Korea.
Abstract
OBJECTIVES: The purpose of the current study was to investiagte the diagnostic accuracy of F18 flucholine (FCH) positron emission tomography/CT (PET/CT) for pre-operative lymph node (LN) staging in newly diagnosed prostate cancer (PCa) patients using meta-analysis. METHODS: PubMed and Embase from the earliest available date of indexing through December 31, 2018, were searched for studies evaluating the diagnostic performance of F18 FCH PET/CT for preoperative LN staging in newly diagnosed PCa. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR + and LR-), and constructed summary receiver operating characteristic curves. RESULTS: Across seven studies (627 patients), the pooled sensitivity was 0.57 [95% confidence interval (CI) (0.42-0.70)] and a pooled specificity of 0.94 [95% CI (0.89-0.97)]. Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 10.2 (95% CI; 5.0-21.0) and negative likelihood ratio (LR-) of 0.46 (95% CI; 0.33-0.64). The pooled diagnostic odds ratio was 22 (95% CI; 9-54). CONCLUSIONS: F18 FCH PET/CT shows a low sensitivity and high specificity for the detection of metastatic LNs in patients with newly diagnosed PCa. Also, F18 FCH PET/CT is only useful for confirmation of LN metastasis (when positive) in PCa patients. ADVANCES IN KNOWLEDGE: F18 FCH PET/CT demonstrates low sensitivity but high specificity for diagnosis of metastatic LNs in patients with newly diagnosed PCa. Also, F18 FCH PET/CT is only useful for confirmation of LN metastasis (when positive) in PCa patients.
OBJECTIVES: The purpose of the current study was to investiagte the diagnostic accuracy of F18 flucholine (FCH) positron emission tomography/CT (PET/CT) for pre-operative lymph node (LN) staging in newly diagnosed prostate cancer (PCa) patients using meta-analysis. METHODS: PubMed and Embase from the earliest available date of indexing through December 31, 2018, were searched for studies evaluating the diagnostic performance of F18 FCH PET/CT for preoperative LN staging in newly diagnosed PCa. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR + and LR-), and constructed summary receiver operating characteristic curves. RESULTS: Across seven studies (627 patients), the pooled sensitivity was 0.57 [95% confidence interval (CI) (0.42-0.70)] and a pooled specificity of 0.94 [95% CI (0.89-0.97)]. Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 10.2 (95% CI; 5.0-21.0) and negative likelihood ratio (LR-) of 0.46 (95% CI; 0.33-0.64). The pooled diagnostic odds ratio was 22 (95% CI; 9-54). CONCLUSIONS: F18 FCH PET/CT shows a low sensitivity and high specificity for the detection of metastatic LNs in patients with newly diagnosed PCa. Also, F18 FCH PET/CT is only useful for confirmation of LN metastasis (when positive) in PCa patients. ADVANCES IN KNOWLEDGE: F18 FCH PET/CT demonstrates low sensitivity but high specificity for diagnosis of metastatic LNs in patients with newly diagnosed PCa. Also, F18 FCH PET/CT is only useful for confirmation of LN metastasis (when positive) in PCa patients.
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