title: Incidental uptake of 18F-fluorodeoxyglucose in the prostate gland. Systematic review and meta-analysis on prevalence and risk of malignancy.
abstract: OBJECTIVE
  To perform a systematic review and meta-analysis of published data on the prevalence and risk of malignancy of prostatic incidental uptake (PIU) detected by fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) or PET/computed tomography (PET/CT).
  
  
  METHODS
  A comprehensive literature search of studies published up to February 2014 was performed. Pooled prevalence and malignancy risk of PIU were calculated on a per patient-based analysis including 95% confidence interval (95%CI). Furthermore, we assessed some parameters as potential predictors of malignant PIU.
  
  
  RESULTS
  Six studies including 47925 patients who underwent 18F-FDG PET/CT were selected. Pooled prevalence of PIU was 1.8% (95%CI: 1.3-2.3%). Overall, 444 patients with PIU were further evaluated and 121 underwent biopsy. The pooled risk of malignancy in patients with PIU further evaluated or verified by biopsy were 17% (95%CI: 12-23%) and 62% (95%CI: 54-71%), respectively. A higher mean age was observed in the group of malignant PIUs compared to benign PIUs. There was a trend towards a higher mean SUV(max) in the group of malignant PIUs but without a statistically significant difference compared to benign PIUs. Peripheric site of PIU but not presence or absence of calcification was a predictor of malignancy.
  
  
  CONCLUSIONS
  PIU is observed in about 1.8% of 18F-FDG PET/CT scans performed in male patients carrying a significant risk of malignancy. Therefore, whenever a PIU is detected further investigation is warranted to exclude malignancy, in particular when PIU is located in the peripheric site of prostate gland.
authors.affiliation: Francesco Bertagna, M.D., Nuclear Medicine, University of Brescia and Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia, Italy, E-mail: francesco.bertagna@spedalicivili.brescia.it, francesco.bertagna@med.unibs.it, Tel. +39/30/399 54 68, Fax +39/30/399 54 20.
authors.forename: F
authors.initials: F
authors.lastname: Bertagna
authors.forename: R
authors.initials: R
authors.lastname: Sadeghi
authors.forename: L
authors.initials: L
authors.lastname: Giovanella
authors.forename: G
authors.initials: G
authors.lastname: Treglia
mesh_terms: D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D015994:Incidence; D033162:Incidental Findings; D008297:Male; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: PET/CT; Prostate; incidental uptake; meta-analysis