title: Diagnostic performance of 18F-dihydroxyphenylalanine positron emission tomography in patients with paraganglioma: a meta-analysis.
abstract: OBJECTIVE
  The aim of this study was to systematically review and conduct a meta-analysis of published data about the diagnostic performance of (18)F-dihydroxyphenylalanine (DOPA) positron emission tomography (PET) in patients with paraganglioma (PG).
  
  
  METHODS
  A comprehensive computer literature search of studies published through 30 June 2011 regarding (18)F-DOPA PET or PET/computed tomography (PET/CT) in patients with PG was performed in PubMed/MEDLINE, Embase and Scopus databases. Pooled sensitivity and specificity of (18)F-DOPA PET or PET/CT in patients with PG on a per patient- and on a per lesion-based analysis were calculated. The area under the receiver-operating characteristic (ROC) curve was calculated to measure the accuracy of (18)F-DOPA PET or PET/CT in patients with PG. Furthermore, a sub-analysis taking into account the different genetic mutations in PG patients was also performed.
  
  
  RESULTS
  Eleven studies comprising 275 patients with suspected PG were included in this meta-analysis. The pooled sensitivity of (18)F-DOPA PET and PET/CT in detecting PG was 91% [95% confidence interval (CI) 87-94%] on a per patient-based analysis and 79% (95% CI 76-81%) on a per lesion-based analysis. The pooled specificity of (18)F-DOPA PET and PET/CT in detecting PG was 95% (95% CI 86-99%) on a per patient-based analysis and 95% (95% CI 84-99%) on a per lesion-based analysis. The area under the ROC curve was 0.95 on a per patient- and 0.94 on a per lesion-based analysis. Heterogeneity between the studies about sensitivity of (18)F-DOPA PET or PET/CT was found. A significant increase in sensitivity of (18)F-DOPA PET or PET/CT was observed when a sub-analysis excluding patients with succinate dehydrogenase subunit B (SDHB) gene mutations was performed.
  
  
  CONCLUSIONS
  In patients with suspected PG (18)F-DOPA PET or PET/CT demonstrated high sensitivity and specificity. (18)F-DOPA PET or PET/CT are accurate methods in this setting. Nevertheless, possible sources of false-negative results should be kept in mind. Furthermore, SDHB gene mutations could influence (18)F-DOPA PET or PET/CT diagnostic performance.
authors.affiliation: Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy. giorgiomednuc@libero.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Treglia
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Cocciolillo
authors.forename: Chiara
authors.initials: C
authors.lastname: de Waure
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Nardo
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Gualano
authors.forename: Paola
authors.initials: P
authors.lastname: Castaldi
authors.forename: Vittoria
authors.initials: V
authors.lastname: Rufini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giordano
mesh_terms: D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D006801:Humans; D064847:Multimodal Imaging / Q000379:methods*; D010235:Paraganglioma / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine