title: 18F-FDG positron emission tomography for the assessment of histological response to neoadjuvant chemotherapy in osteosarcomas: a meta-analysis.
abstract: OBJECTIVE
  The purpose of this meta-analysis was to evaluate the predicting value of fluorine-18-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET-CT) in the assessment of histological response to neoadjuvant chemotherapy in patients with osteosarcomas.
  
  
  METHODS
  A detailed search was made in MEDLINE, EMBASE and the Web of Knowledge for relevant original articles published in English; methodological quality of the included studies were also assessed. Two reviewers extracted data independently. Sufficient data was presented to construct a 2 × 2 contingency table. Pooled sensitivity and specificity, positive and negative likelihood ratios were estimated. A summary receiver operating characteristic curve (SROC) was constructed with the Moses' constant of linear model. A χ(2) test was performed to test for heterogeneity.
  
  
  RESULTS
  Eight studies comprising 178 patients met the inclusion criteria. The pooled sensitivity and specificity for standardized uptake values (SUV) after chemotherapy (SUV2) ≤ 2.5 were 0.734 (95% CI, 0.537-0.867) and 0.864 (95% CI, 0.510-0.975), for the ratio of standardized uptake values after (SUV2) to before (SUV1) chemotherapy SUV 2:1 ≤ 0.5 were 0.690 (95% CI, 0.497-0.833) and 0.653 (95% CI, 0.492-0.786), the positive and negative likelihood ratio (LR+/LR-) for SUV2 ≤ 2.5 were 5.397 (95% CI, 1.169-24.920) and 0.308 (95% CI, 0.165-0.577), for SUV 2:1 ≤ 0.5 were 1.989 (95% CI, 1.145-3.457) and 0.475 (95% CI, 0.247-0.915). There was no significant difference between-study heterogeneity for either LR + or LR- in any of these analyses. The area under the SROC curve for SUV2 ≤ 2.5 and SUV 2:1 ≤ 0.5 were 0.81 and 0.72, respectively.
  
  
  CONCLUSIONS
  The present meta-analysis showed that 18F-FDG PET-CT scan, as measured by the SUV before and after treatment, SUV2 ≤ 2.5 and SUV 2:1 ≤ 0.5 are valuable for predicting the histological response to chemotherapy. SUV2 ≤ 2.5 have better predicting performance than SUV 2:1 ≤ 0.5.
authors.affiliation: Department of Oncology, Affiliated Sixth People's Hospital, Shanghai Jiaotong University, Yishan Road 600#, 200233 Shanghai, People's Republic of China. lhtmed@yahoo.com.cn
authors.forename: Li
authors.initials: L
authors.lastname: Hongtao
authors.forename: Zhao
authors.initials: Z
authors.lastname: Hui
authors.forename: Wang
authors.initials: W
authors.lastname: Bingshun
authors.forename: Wang
authors.initials: W
authors.lastname: Xiaojin
authors.forename: Wang
authors.initials: W
authors.lastname: Zhiyu
authors.forename: Zheng
authors.initials: Z
authors.lastname: Shuier
authors.forename: He
authors.initials: H
authors.lastname: Aina
authors.forename: Sun
authors.initials: S
authors.lastname: Yuanjue
authors.forename: Min
authors.initials: M
authors.lastname: Daliu
authors.forename: Shen
authors.initials: S
authors.lastname: Zan
authors.forename: Yao
authors.initials: Y
authors.lastname: Yang
mesh_terms: D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D015201:Meta-Analysis as Topic; D020360:Neoadjuvant Therapy; D012516:Osteosarcoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18