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Medicine (Baltimore). 2017 May;96(19):e6676. doi: 10.1097/MD.0000000000006676.

Diagnostic accuracy of SPECT, PET, and MRS for primary central nervous system lymphoma in HIV patients: A systematic review and meta-analysis.

Author information

1
aDepartment of Neurology, The Second Xiangya Hospital, Changsha City, Hunan Province, China bDepartment of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA cCancer Research Institute, Central South University, Changsha City, Hunan Province, China dDepartment of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA eDepartment of Radiology, The Second Xiangya Hospital fDepartment of Pathology, The First Xiangya Hospital, Changsha City, Hunan Province, China gDepartment of Pathology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA hDepartment of Neurology, The First Xiangya Hospital, Changsha City, Hunan Province, China.

Abstract

BACKGROUND:

We performed a systematic review and meta-analysis to assess the roles of SPECT, PET, and MRS in distinguishing primary central nervous system lymphoma (PCNSL) from other focal brain lesions (FBLs) in human immunodeficiency virus (HIV)-infected patients.

METHODS:

PubMed, Scopus, and Medline were systematically searched for eligible studies from 1980 to 2016. Two authors extracted characteristics of patients and their lesions using predefined criteria.

RESULTS:

Eighteen studies on SPECT containing 667 patients, 6 studies on PET containing 108 patients, and 3 studies on MRS containing 96 patients were included. SPECT had a pooled sensitivity of 0.92 (95% CI: 0.85-0.96) and specificity of 0.84 (95% CI: 0.74-0.90) in differentiating PCNSL from other FBLs. For the 6 studies that used only pathology and/or serology as the gold standard, the pooled sensitivity was 0.85 (95% CI: 0.72-0.97) and the pooled specificity was 0.73 (95% CI: 0.54-0.92).

CONCLUSION:

SPECT has good diagnostic accuracy for discriminating PCNSL from other FBL-causing disorders in HIV patients. However, the actual sensitivity and specificity of SPECT may be lower than expected if only pathology and/or serology was used as the gold standard. PET may be superior but has less supporting clinical data and is more expensive.

PMID:
28489744
PMCID:
PMC5428578
DOI:
10.1097/MD.0000000000006676
[Indexed for MEDLINE]
Free PMC Article
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