Yi Gong1, Zhiyong Guo2, Xiufa Tang2, Chunjie Li3, Qingming Wang4. 1. Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanchang University, Nanchang, China. 2. Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China. 3. Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China, lichunjie@scu.edu.cn. 4. Department of Hematology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Abstract
OBJECT: The purpose of this review is to assess the diagnostic performance of different imaging techniques for the detection of para-aortic lymph node (PALN) metastasis from gynecological malignancies. METHODS: Six databases, from the earliest available date of indexing through July 22, 2018, were systematically searched. In addition, the reference lists of relevant articles were searched by hand. Study allocation, data extraction, and quality assessment were independently performed by 2 reviewers. The size effect, sensitivity (SEN), specificity (SPE), positive likelihood ratio, negative likelihood ratio, diagnostic OR, and 95% CIs were used in the meta-analysis. The area under the curve (AUC) and Q* were calculated to reflect the synthesized diagnostic accuracy. Statistical calculations of this meta-analysis were conducted using STATA version 14.0 software. RESULTS: Across 41 eligible studies (1,615 participants), pooled SEN, SPE, and AUC of magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), PET-CT, and lymphangiography analyses were 25%, 93%, 0.7675; 60%, 94%, 0.9050; 83%, 96%, 0.9422; 66%, 97%, 0.9501; 77%, 75%, 0.8332, respectively. Analysis of combined summary receiver operating characteristic curves indicated that PET and PET-CT were superior to other imaging modalities. CONCLUSION: The present meta-analysis demonstrated that PET and PET-CT should be the first choice for detecting PALN metastasis in gynecological malignancies. CT was also suitable for confirmation. MRI was not recommended. Further studies are needed for PALN assessment.
OBJECT: The purpose of this review is to assess the diagnostic performance of different imaging techniques for the detection of para-aortic lymph node (PALN) metastasis from gynecological malignancies. METHODS: Six databases, from the earliest available date of indexing through July 22, 2018, were systematically searched. In addition, the reference lists of relevant articles were searched by hand. Study allocation, data extraction, and quality assessment were independently performed by 2 reviewers. The size effect, sensitivity (SEN), specificity (SPE), positive likelihood ratio, negative likelihood ratio, diagnostic OR, and 95% CIs were used in the meta-analysis. The area under the curve (AUC) and Q* were calculated to reflect the synthesized diagnostic accuracy. Statistical calculations of this meta-analysis were conducted using STATA version 14.0 software. RESULTS: Across 41 eligible studies (1,615 participants), pooled SEN, SPE, and AUC of magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), PET-CT, and lymphangiography analyses were 25%, 93%, 0.7675; 60%, 94%, 0.9050; 83%, 96%, 0.9422; 66%, 97%, 0.9501; 77%, 75%, 0.8332, respectively. Analysis of combined summary receiver operating characteristic curves indicated that PET and PET-CT were superior to other imaging modalities. CONCLUSION: The present meta-analysis demonstrated that PET and PET-CT should be the first choice for detecting PALN metastasis in gynecological malignancies. CT was also suitable for confirmation. MRI was not recommended. Further studies are needed for PALN assessment.
Authors: Ahmed Ebada Salem; Gabriel C Fine; Matthew F Covington; Bhasker R Koppula; Richard H Wiggins; John M Hoffman; Kathryn A Morton Journal: Cancers (Basel) Date: 2022-06-18 Impact factor: 6.575