title: Predicting extracapsular spread of head and neck cancers using different imaging techniques: a systematic review and meta-analysis.
abstract: This study compared the diagnostic ability of computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US), and positron emission tomography/CT (PET/CT) for extracapsular spread. MEDLINE, EMBASE, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Sciencepaper Online databases were searched. The mean sensitivity of CT was 0.77, specificity was 0.85, positive likelihood ratio (LR+) was 4.839, negative likelihood ratio (LR-) was 0.287, diagnostic odds ratio (DOR) was 19.239, area under the summary receiver operating characteristic curve (AUC) was 0.8615, and Q* was 0.7922. The mean sensitivity of MRI was 0.85, specificity was 0.84, LR+ was 4.615, LR- was 0.191, DOR was 60.270, AUC was 0.9454, and Q* was 0.8844. The sensitivity and specificity of PET/CT were both 0.86. The mean sensitivity of US was 0.87 and specificity was 0.75. Overall, CT had the lowest sensitivity (P=0.0355); specificity was similar for all methods (P=0.1159). CT and MRI had equivalent summary diagnostic efficacy (AUC and Q*) (P>0.05). This evidence indicates that CT might have a relatively lower sensitivity when diagnosing ECS, and that CT and MRI may be similarly effective in diagnosing ECS. MRI showed positive trends in diagnosing ECS. Evidence was lacking for PET/CT and US diagnosis. More related studies are required to confirm these inconclusive results.
authors.affiliation: State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Su
authors.affiliation: State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Duan
authors.affiliation: State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China.
authors.forename: W
authors.initials: W
authors.lastname: Pan
authors.affiliation: State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China.
authors.forename: C
authors.initials: C
authors.lastname: Wu
authors.affiliation: Department of Ultrasound, No. 4 West China Teaching Hospital, Sichuan University, Chengdu, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Jia
authors.affiliation: Department of Head and Neck Oncology, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China. Electronic address: paulhanbo@163.com.
authors.forename: B
authors.initials: B
authors.lastname: Han
authors.affiliation: Department of Head and Neck Oncology, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China. Electronic address: lichunjie07@qq.com.
authors.forename: C
authors.initials: C
authors.lastname: Li
mesh_terms: D003952:Diagnostic Imaging; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology*; D011237:Predictive Value of Tests
keywords: computed tomography; extracapsular spread; head and neck cancer; magnetic resonance imaging; positron emission tomography/computed tomography; ultrasonography