title: Usefulness of F-18-fluorodeoxyglucose positron emission tomography to confirm suspected pancreatic cancer: a meta-analysis.
abstract: BACKGROUND
  Pancreatic cancer is among the five most lethal malignancies in the world. Unfortunately, many malignant tumors go undetected by the current primary diagnostic tools. (18)FDG-PET and (18)FDG-PET/CT might be useful to confirm suspected pancreatic cancer.
  
  
  METHODS
  A meta-analysis was performed using all major search engines. Methodological quality of included studies was assessed as well as quality of the PET-protocol. The following pooled estimates served as primary outcome measures: sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy.
  
  
  RESULTS
  Thirty-five studies were included. Pooled estimates for (18)FDG-PET were: sensitivity 90%, specificity 76%, PPV 90%, NPV 76% and accuracy 86%. Pooled estimates for (18)FDG-PET/CT were: sensitivity 90%, specificity 76%, PPV 89%, NPV 78% and accuracy 86%. The pooled sensitivity and specificity for (18)FDG-PET to differentiate between pancreatic cancer and chronic pancreatitis were 90% and 84%, respectively.
  
  
  CONCLUSIONS
  Both (18)FDG-PET and (18)FDG-PET/CT offer no benefit over the current primary diagnostic tools in diagnosing pancreatic cancer. However, the (18)FDG-PET/CT systems are still improving. We should investigate the sensitivity and specificity of these new systems while reevaluating the tradeoff between false positive and false negative results. Yet, (18)FDG-PET/CT may have a role in the staging of pancreatic cancer, in survival prediction, and may add to other diagnostic information, like histology.
authors.affiliation: Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: A P
authors.initials: AP
authors.lastname: Rijkers
authors.affiliation: Department of Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Valkema
authors.affiliation: Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: Duivenvoorden
authors.affiliation: Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. Electronic address: c.vaneijck@erasmusmc.nl.
authors.forename: C H J
authors.initials: CH
authors.lastname: van Eijck
mesh_terms: D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Diagnostic imaging; Meta-analysis; Pancreatic neoplasms; Positron-emission tomography; Review