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Eur J Nucl Med Mol Imaging. 2016 May;43(5):860-70. doi: 10.1007/s00259-015-3242-z. Epub 2015 Dec 3.

Assessing the role of ¹⁸F-FDG PET and ¹⁸F-FDG PET/CT in the diagnosis of soft tissue musculoskeletal malignancies: a systematic review and meta-analysis.

Author information

1
Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, 1400 Pressler, FCT 16.6005, Unit 1483, Houston, TX, 77030, USA. Ecetchebehere@mdanderson.org.
2
Department of Nuclear Medicine, Sirio Libanes Hospital, São Paulo, Brazil. Ecetchebehere@mdanderson.org.
3
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
4
Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
5
Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
6
Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, 1400 Pressler, FCT 16.6005, Unit 1483, Houston, TX, 77030, USA.

Abstract

PURPOSE:

Twelve years ago a meta-analysis evaluated the diagnostic performance of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in assessing musculoskeletal soft tissue lesions (MsSTL). Currently, PET/CT has substituted PET imaging; however, there has not been any published meta-analysis on the use of PET/CT or a comparison of PET/CT with PET in the diagnosis of MsSTL. Therefore, we conducted a meta-analysis to identify the current diagnostic performance of (18)F-FDG PET/CT and determine if there is added value when compared to PET.

METHODS:

A systematic review of English articles was conducted, and MEDLINE PubMed, the Cochrane Library, and Embase were searched from 1996 to March 2015. Studies exploring the diagnostic accuracy of (18)F-FDG PET/CT (or dedicated PET) compared to histopathology in patients with MsSTL undergoing investigation for malignancy were included.

RESULTS:

Our meta-analysis included 14 articles composed of 755 patients with 757 soft tissue lesions. There were 451 (60 %) malignant tumors and 306 benign lesions. The (18)F-FDG PET/CT (and dedicated PET) mean sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for diagnosing MsSTL were 0.96 (0.90, 1.00), 0.77 (0.67, 0.86), 0.88 (0.85, 0.91), 0.86 (0.78, 0.94), and 0.91 (0.83, 0.99), respectively. The posterior mean (95 % highest posterior density interval) for the AUC was 0.92 (0.88, 0.96). PET/CT had higher specificity, accuracy, and positive predictive value when compared to a dedicated PET (0.85, 0.89, and 0.91 vs 0.71, 0.85, and 0.82, respectively).

CONCLUSION:

(18)F-FDG PET/CT and dedicated PET are both highly accurate in the diagnosis of MsSTL. PET/CT is more accurate and specific and has a higher positive predictive value than PET.

KEYWORDS:

18F-FDG; Meta-analysis; Musculoskeletal; PET/CT; Sarcoma; Soft tissue tumors

PMID:
26631240
PMCID:
PMC5048410
DOI:
10.1007/s00259-015-3242-z
[Indexed for MEDLINE]
Free PMC Article

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