title: Different imaging techniques for the detection of pelvic lymph nodes metastasis from gynecological malignancies: a systematic review and meta-analysis.
abstract: OBJECTIVE
  This study aimed to evaluate the diagnostic performance of different imaging techniques and the corresponding diagnostic criteria for preoperative detection of pelvic lymph node metastasis from gynecological carcinomas.
  
  
  METHODS
  Six databases were systematically searched for retrieving eligible studies. Study inclusion, data extraction and risk of bias assessment were performed by 2 reviewers independently. STATA 14.0 was used to perform the meta-analysis.
  
  
  RESULTS
  Eighty eligible studies were collected. The pooled sensitivity, specificity, and area under curve (AUC) of CT, MRI and DWI were 47%, 93%, 0.7424; 50%, 95%, 0.8039 and 84%, 95%, 0.9523 respectively. As regards PET, PET-CT and US, the pooled sensitivity, specificity and AUC were 56%, 97%, 0.9592; 68%, 97%, 0.9363 and 71%, 99%, 0.9008 respectively. The summary receiver operating characteristic (SROC) curve indicated that the systematic diagnostic performances of PET, PET-CT, DWI were superior to other imaging modalities.
  
  
  CONCLUSIONS
  The present work demonstrated that DWI, PET, PET-CT were the top-priority consideration of imaging modalities for detecting metastatic pelvic lymph node in gynecological carcinoma. DWI was recommended as the first choice for metastasis exclusion and all the other imaging techniques including CT and MRI were suitable for metastasis conformation. However, for the early stage lymph node malignancy, PET or PET-CT could represent a better choice. More studies exploring the diagnostic efficacy of detailed criteria are required in the future.
authors: Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
authors: Yi
authors: Y
authors: Gong
authors: Department of Hematology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
authors: Qingming
authors: Q
authors: Wang
authors: Department of Cardiology, The Second Affiliated Hospital of Southwest Medical University, Lu Zhou, Sichuan, China.
authors: Li
authors: L
authors: Dong
authors: Department of Ultrasound, No.4 West China Teaching Hospital, Sichuan University, Chengdu, China.
authors: Yiping
authors: Y
authors: Jia
authors: Department of Oral and Maxillofacial Surgery, Department of Evidence-based Dentistry, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.
authors: Chengge
authors: C
authors: Hua
authors: Department of Stomatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
authors: Fanglin
authors: F
authors: Mi
authors: Department of Head and Neck Oncology, Department of Evidence-based Dentistry, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.
authors: Chunjie
authors: C
authors: Li
mesh_terms: D019540:Area Under Curve; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D005833:Genital Neoplasms, Female / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D010388:Pelvis; D012372:ROC Curve; D012680:Sensitivity and Specificity
keywords: gynecological malignance; imaging technique; metastasis; pelvic lymph node; systematic review and meta-analysis