title: 18 F-fluorodeoxyglucose positron emission tomography to evaluate recurrent gastric cancer: a systematic review and meta-analysis.
abstract: OBJECTIVE
  We aimed to explore the role of the diagnostic accuracy of (18) F-fluorodeoxyglucose positron emission tomography ((18) F-FDG PET) in detecting recurrent gastric cancer through a systematic review and meta-analysis.
  
  
  METHODS
  The MEDLINE, EMBASE, Cancerlit, and Cochrane Library database, from January 2001 to July 2011, were searched for studies evaluating the diagnostic performance of (18) F-FDG PET in detecting recurrent gastric cancer. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic curves. We also compared the performance of (18) F-FDG PET with computed tomography (CT) by analyzing studies that had also used these diagnostic methods on the same patients.
  
  
  RESULTS
  Across nine studies (526 patients), the overall sensitivity of (18) F-FDG PET was 0.78 (95% confidence interval [CI]: 0.68-0.86), and the overall specificity was 0.82 (95% CI: 0.76-0.87). Overall, LR+ was 3.52 (95% CI: 2.68-4.63) and LR- was 0.32 (95% CI: 0.22-0.46). In studies in which both (18) F-FDG PET and other diagnostic tests were performed, the sensitivity and specificity of (18) F-FDG PET were 0.72 (95% CI: 0.62-0.80) and 0.84 (95% CI: 0.77-0.90), respectively; of contrast CT, they were 0.74 (95% CI: 0.64-0.83) and 0.85 (95% CI: 0.78-0.90), respectively; and of combined PET and CT, they were 0.75 (95% CI: 0.67-0.82) and 0.85 (95% CI 0.79-0.90), respectively. Study sensitivity was not correlated with the prevalence of recurrent gastric cancer.
  
  
  CONCLUSIONS
  (18) F-FDG PET has good diagnostic performance in the overall evaluation of recurrent gastric cancer, but still has some limited performance compared with contrast CT. (18) F-FDG PET combined with CT might improve the diagnostic performance in detecting recurrent gastric cancer.
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Lian-Ming
authors.initials: LM
authors.lastname: Wu
authors.forename: Jia-Ni
authors.initials: JN
authors.lastname: Hu
authors.forename: Jia
authors.initials: J
authors.lastname: Hua
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Gu
authors.forename: Jiong
authors.initials: J
authors.lastname: Zhu
authors.forename: Jian-Rong
authors.initials: JR
authors.lastname: Xu
mesh_terms: D003287:Contrast Media; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016013:Likelihood Functions; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18