Diagnostic value of (18)F-FDG PET for evaluation of paraaortic nodal metastasis in patients with cervical carcinoma: a metaanalysis.
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.


CONCLUSIONS
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.
Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. sokbom@ncc.re.kr
Sokbom
S
Kang
Seok-Ki
SK
Kim
Dae-Chul
DC
Chung
Sang-Soo
SS
Seo
Joo-Young
JY
Kim
Byung-Ho
BH
Nam
Sang-Yoon
SY
Park
D001011:Aorta; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000473:pathology*
D019788:Fluorodeoxyglucose F18