title: Accuracy of 18F-FDG PET/CT for diagnosing inguinal lymph node involvement in penile squamous cell carcinoma: systematic review and meta-analysis of the literature.
abstract: OBJECTIVE
  Metastatic involvement of the inguinal lymph nodes is associated with decreased survival and is a strong prognostic factor in penile squamous cell carcinoma. The aim of the current systematic review was to evaluate the accuracy of (18)F-FDG PET/CT for inguinal lymph node staging in penile squamous cell carcinoma and possible influential factors.
  
  
  METHODS
  Medline, SCOPUS, Springer, Science Direct, and Google Scholar were searched using the key words "(penile or penis) and PET," with no date or language limitation. The meeting abstracts were not excluded either. Statistical pooling was performed using the random-effects model.
  
  
  RESULTS
  Seven studies were included in the meta-analysis. One article had 2 different subgroups of patients, and each subgroup was considered as a separate study. Pooled sensitivity and specificity were 80.9% (95% confidence interval [CI]: 69.5%-89.4%) and 92.4% (95% CI: 86.8%-96.2%), respectively. Pooled sensitivity was 96.4% (95% CI: 81.7%-99.9%) for cN+ and 56.5% (95% CI: 34.5%-76.8%) for cN0 patients.
  
  
  CONCLUSIONS
  (18)F-FDG PET/CT imaging has relatively low sensitivity (especially in cN0 patients) for detection of inguinal lymph node involvement in penile cancer patients, which does not justify its routine use. However, patients with clinically palpable lymph nodes may benefit from (18)F-FDG PET/CT because the sensitivity in this subgroup of patients is high.
authors.affiliation: Nuclear Medicine Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Imam Reza Hospital, Mashhad, Iran. sadeghir@mums.ac.ir
authors.forename: Ramin
authors.initials: R
authors.lastname: Sadeghi
authors.forename: Hassan
authors.initials: H
authors.lastname: Gholami
authors.forename: Seyed Rasoul
authors.initials: SR
authors.lastname: Zakavi
authors.forename: Vahid Reza Dabbagh
authors.initials: VR
authors.lastname: Kakhki
authors.forename: Simon
authors.initials: S
authors.lastname: Horenblas
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D019788:Fluorodeoxyglucose F18; D018740:Genetic Heterogeneity; D006801:Humans; D007264:Inguinal Canal / Q000000981:diagnostic imaging* / Q000473:pathology; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D064847:Multimodal Imaging; D010412:Penile Neoplasms / Q000145:classification / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D017594:Publication Bias; D011785:Quality Assurance, Health Care; D012372:ROC Curve; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18