Diagnostic performance of 18F-FDG PET or PET/CT in restaging renal cell carcinoma: a systematic review and meta-analysis.
BACKGROUND
In recent years, fluorine-18-fluorodeoxyglucose (F-FDG) PET or PET/computed tomography (PET/CT) has emerged as a valuable method for restaging of cancer. The aim of this study was to evaluate its diagnostic performance for detecting metastatic or recurrent lesions in patients with renal cell carcinoma (RCC).


METHODS
Several databases were searched for relevant articles on F-FDG PET or PET/CT for the restaging of RCC. Two researchers independently selected studies, extracted data, and assessed the methodological quality according to the QUADAS-2 tool. On a per-patient basis, we determined the pooled sensitivity, specificity, diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio. Summary receiver-operating characteristic curves were also constructed with the area under the curve and Q* index obtained.


RESULTS
A total of 15 studies involving 1168 patients fulfilled the inclusion criteria. After excluding one study on the basis of the sensitivity analysis, the pooled estimates of 14 studies were 0.86 [95% confidence interval (CI), 0.88-0.93] for sensitivity, 0.88 (95% CI, 0.84-0.91) for specificity, 5.85 (95% CI, 4.27-8.03) for positive likelihood ratio, 0.18 (95% CI, 0.12-0.26) for negative likelihood ratio, and 42.12 (95% CI, 21.56-82.28) for diagnostic odds ratio. The area under the curve and Q* estimates were 0.9310 and 0.8663, respectively.


CONCLUSIONS
Current evidence suggests that F-FDG PET or PET/CT is a valuable tool in the detection of metastatic or recurrent lesions in patients with RCC. More prospective studies on PET or PET/CT in the restaging of RCC are still needed.
aKey Laboratory of Radiation Physics and Technology, Ministry of Education, Institute of Nuclear Science and Technology Departments of bNuclear Medicine cEvidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, China.
Huan
H
Ma
Guohua
G
Shen
Bin
B
Liu
Yuanyou
Y
Yang
Pengwei
P
Ren
Anren
A
Kuang
D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography / Q000706:statistics & numerical data; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18