title: High Diagnostic Value of 18F-FDG PET/CT in Endometrial Cancer: Systematic Review and Meta-Analysis of the Literature.
abstract: The aim of this study was to evaluate the diagnostic performance of (18)F-FDG PET/CT for the preoperative assessment of lymph node metastases (LNM) in endometrial cancer patients and for the assessment of endometrial cancer recurrence (ECR) after primary surgical treatment.
  
  
  METHODS
  A comprehensive search was performed on Pubmed/MEDLINE databases for studies reporting the diagnostic performance of (18)F-FDG PET/CT for assessment of LNM and ECR published up to August 15, 2015. Twenty-one studies (13 for LNM and 8 for ECR) were included in the systematic review and meta-analysis. Pooled estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of the (18)F-FDG PET/CT were calculated along with 95% confidence intervals (CIs). A summary receiver-operating-characteristics curve (SROC) was constructed, and the area under the SROC curve (AUC) was determined along with Q* index.
  
  
  RESULTS
  The overall pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and AUC (with 95% CI) of (18)F-FDG PET/CT for detection of LNM were 0.72 (95% CI, 0.63-0.80), 0.94 (95% CI, 0.93-0.96), 10.9 (95% CI, 7.9-15.1), 0.36 (95% CI, 0.27-0.48), 39.7 (95% CI, 21.4-73.6), and 0.94 (95% CI, 0.85-0.99), respectively, whereas the corresponding numbers for detection of ECR were 0.95 (95% CI, 0.91-0.98), 0.91 (95% CI, 0.86-0.94), 8.8 (95% CI, 6.0-12.7), 0.08 (95% CI, 0.05-0.15), 171.7 (95% CI, 67.9-434.3), and 0.97 (95% CI, 0.95-0.98), respectively. The overall diagnostic accuracy (Q* index) in LNM and ECR were 0.88 and 0.93, respectively.
  
  
  CONCLUSIONS
  (18)F-FDG PET/CT has an excellent diagnostic performance for detecting LNM preoperatively and disease recurrence postoperatively in endometrial cancer patients.
authors.affiliation: Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway Center for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway vikram.bollineni@uib.no.
authors.forename: Vikram Rao
authors.initials: VR
authors.lastname: Bollineni
authors.affiliation: Department of Radiology, Haukeland University Hospital, Bergen, Norway Department of Clinical Medicine, University of Bergen, Bergen, Norway;
authors.forename: Sigmund
authors.initials: S
authors.lastname: Ytre-Hauge
authors.affiliation: Department of Quantitative Economics, School of Business and Economics, Maastricht University, Maastricht, The Netherlands.
authors.forename: Oksana
authors.initials: O
authors.lastname: Bollineni-Balabay
authors.affiliation: Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway Center for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Helga Birgitte
authors.initials: HB
authors.lastname: Salvesen
authors.affiliation: Department of Radiology, Haukeland University Hospital, Bergen, Norway Department of Clinical Medicine, University of Bergen, Bergen, Norway;
authors.forename: Ingfrid Salvesen
authors.initials: IS
authors.lastname: Haldorsen
mesh_terms: D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D012008:Recurrence
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: FDG; PET and CT; endometrial cancer