title: Pretransplant FDG-PET in aggressive non-Hodgkin lymphoma: systematic review and meta-analysis.
abstract: This study aimed to systematically review and meta-analyze the value of pretransplant FDG-PET in predicting outcome after autologous stem cell transplantation in aggressive non-Hodgkin lymphoma. MEDLINE was systematically searched; included studies were methodologically assessed and meta-analyzed, when possible. Overall methodological quality of included studies (n = 11) was poor, with moderate risk of bias in the domains of study participation (n = 7) and prognostic factor measurement (n = 7), and high risk of bias in the domains of outcome measurement (n = 10), and study confounding (n = 11). In all aggressive non-Hodgkin lymphomas, pooled sensitivity and specificity were 54.0% and 73.1% in predicting treatment failure, and 54.5% and 68.7% in predicting death. Because of interstudy heterogeneity, additional subgroup analyses were performed. In newly diagnosed aggressive non-Hodgkin lymphoma, pooled sensitivity and specificity were 20.0% and 70.0% in predicting treatment failure, and 8.3% % and 30.5% in predicting death. In refractory/relapsed aggressive non-Hodgkin lymphoma, pooled sensitivity and specificity were 68.1% and 72.1% in predicting treatment failure, and 77.3% and 69.6% in predicting death. At present, pretransplant FDG-PET cannot be recommended in aggressive non-Hodgkin lymphoma, because available studies suffer from major methodological flaws, and reported prognostic estimates are low (i.e., poor in newly diagnosed and moderate in refractory/relapsed aggressive non-Hodgkin lymphoma).
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Hugo J A
authors.initials: HJ
authors.lastname: Adams
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Kwee
mesh_terms: D005260:Female; D019298:Glucose-6-Phosphate / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging* / Q000401:mortality; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests
chemical_list: C047515:2-fluoro-2-deoxyglucose-6-phosphate; D019298:Glucose-6-Phosphate
keywords: 18F-fluoro-2-deoxy-d-glucose positron emission tomography; autologous stem cell transplantation; lymphoma; meta-analysis; systematic review