title: Diagnostic performance of fluorine-18-fluorodeoxyglucose positron emission tomography in the postchemotherapy management of patients with seminoma: systematic review and meta-analysis.
abstract: OBJECTIVE
  To meta-analyze published data about the diagnostic performance of fluorine-18-Fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) and PET/computed tomography (PET/CT) in the postchemotherapy management of patients with seminoma.
  
  
  METHODS
  A comprehensive literature search of studies published through January 2014 on this topic was performed. All retrieved studies were reviewed and qualitatively analyzed. Pooled sensitivity and specificity, positive and negative predictive values (PPV and NPV), accuracy, and area under the summary ROC curve (AUC) of (18)F-FDG-PET or PET/CT on a per examination-based analysis were calculated. Subgroup analyses considering the size of residual/recurrent lesions were carried out.
  
  
  RESULTS
  Nine studies including 375 scans were selected. The pooled analysis provided the following results: sensitivity 78% (95% confidence interval (95% CI): 67-87%), specificity 86% (95% CI: 81-89%), PPV 58% (95% CI: 48-68%), NPV 94% (95% CI: 90-96%), and accuracy 84% (95% CI: 80-88%). The AUC was 0.90. A better diagnostic accuracy of (18)F-FDG-PET or PET/CT in evaluating residual/recurrent lesions >3 cm compared to those <3 cm was found.
  
  
  CONCLUSIONS
  (18)F-FDG-PET and PET/CT were demonstrated to be accurate imaging methods in the postchemotherapy management of patients with seminoma; nevertheless possible sources of false-negative and false-positive results should be considered. The literature focusing on this setting still remains limited and cost-effectiveness analyses are warranted.
authors: Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Via Ospedale 12, 6500 Bellinzona, Switzerland.
authors: Giorgio
authors: 0000-0001-9808-780X
authors: G
authors: Treglia
authors: Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors: Ramin
authors: R
authors: Sadeghi
authors: Institute of Nuclear Medicine, Catholic University of the Sacred Heart, 00168 Rome, Italy.
authors: Salvatore
authors: S
authors: Annunziata
authors: Institute of Nuclear Medicine, Catholic University of the Sacred Heart, 00168 Rome, Italy.
authors: Carmelo
authors: 0000-0002-1047-3333
authors: C
authors: Caldarella
authors: Department of Nuclear Medicine, University of Brescia and Spedali Civili, 25123 Brescia, Italy.
authors: Francesco
authors: F
authors: Bertagna
authors: Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Via Ospedale 12, 6500 Bellinzona, Switzerland.
authors: Luca
authors: L
authors: Giovanella
mesh_terms: D019788:Fluorodeoxyglucose F18 / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D011859:Radiography; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D018239:Seminoma / Q000000981:diagnostic imaging / Q000188:drug therapy; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18