title: Diagnostic performance of positron emission tomography/computed tomography using fluorine-18 fluorodeoxyglucose in detecting locoregional nodal involvement in patients with anal canal cancer: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The diagnostic performance of positron emission tomography using (18)F-fluorodeoxyglucose (FDG-PET) in detecting nodal involvement in patients with anal canal cancer (ACC) has been investigated by several studies with conflicting results. The aim of our study is to systematically review and meta-analyze published data about this topic.
  
  
  METHODS
  A comprehensive computer literature search of PubMed/MEDLINE, Scopus, and Embase databases was carried out on July 10 to find relevant articles concerning the diagnostic performance of FDG-PET in detecting locoregional nodal involvement in patients with ACC. No language restriction was used. Pooled diagnostic performance on a lesion-based analysis was calculated.
  
  
  RESULTS
  Seven retrospective and five prospective studies have been reviewed. Six studies allowed assessing pooled sensitivity; five studies allowed assessing pooled specificity. Sensitivity and specificity values of FDG-PET/CT on a lesion-based analysis ranged from 31 to 100% and from 53 to 98%, with pooled estimates of 56% (95% CI: 45-67%) and 90% (95% CI: 86-93%), respectively.
  
  
  CONCLUSIONS
  Our meta-analysis demonstrates that FDG-PET is a specific diagnostic tool in detecting locoregional lymph node involvement in patients with ACC. Low sensitivity is a major concern; however, higher sensitivity could be reached combining FDG-PET with MR scan.
authors.affiliation: Institute of Nuclear Medicine, Department of Radiological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy ; Institute of Nuclear Medicine, Department of Bioimaging and Radiological Sciences, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168 Rome, Italy.
authors.forename: Carmelo
authors.identifier: 0000-0002-1047-3333
authors.initials: C
authors.lastname: Caldarella
authors.affiliation: Institute of Nuclear Medicine, Department of Radiological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Annunziata
authors.affiliation: Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Treglia
authors.affiliation: Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Sadeghi
authors.affiliation: Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Narjes
authors.initials: N
authors.lastname: Ayati
authors.affiliation: Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
authors.forename: Luca
authors.initials: L
authors.lastname: Giovanella
mesh_terms: D001005:Anus Neoplasms / Q000473:pathology*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18