Diagnostic accuracy of 18F-FDG PET or PET/CT for the characterization of adrenal masses: a systematic review and meta-analysis
Year: 2018
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Objective: We aimed to explore the role of the diagnostic accuracy of 18F fluodeoxyglucose PET (18F-FDG PET) or PET/CT for characterization of adrenal lesions through a systematic review and meta-analysis. Methods: The MEDLINE, EMBASE, and Cochrane Library database, from the earliest available date of indexing through 30 April 2017, were searched for studies evaluating the diagnostic performance of 18F-FDG PET or PET/CT for characterization of adrenal lesions. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR + and LR–), and constructed summary receiver operating characteristic curves. Results: Across 29 studies (2421 patients), the pooled sensitivity for 18F-FDG PET or PET/CT was 0.91 [95% CI (0.88–0.94)] with heterogeneity (χ 2 = 141.8, p = 0.00) and a pooled specificity of 0.91 [95% CI (0.87–0.93)] with heterogeneity (χ 2 = 113.7, p = 0.00). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 9.9 [95% CI (7.1–13.7)] and negative likelihood ratio (LR–) of 0.09 [95% CI (0.07–0.13)]. The pooled diagnostic odds ratio was 105 [95% CI (63–176)]. In metaregression analysis, study design, publication year, study location (western vs others), interpretation criteria of PET or PET/CT images, quantification of PET or PET/CT [SUVmax (maximum standardized uptake value) vs SUV (standardized uptake value) ratio], patient group, and analysis method (patient-based vs lesion-based) were the sources of the study heterogeneity. However, in multivariate metaregression, no definite variable was the source of the study heterogeneity. Conclusion: 18F-FDG PET or PET/CT demonstrated good sensitivity and specificity for the characterization of adrenal masses. At present, the literature regarding the use of 18F-FDG PET or PET/CT for the characterization of adrenal masses remains still limited; thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of 18F-FDG PET or PET/CT characterization of adrenal masses. Advances in knowledge: 18F- FDG PET or PET/CT showed good sensitivity and specificity for the characterization of adrenal masses and could provide additional information for that purpose.
Source: British Journal of Radiology
DOI: 10.1259/bjr.20170520
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2783166877