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Meta-Analysis
. 2013 Aug 7;19(29):4808-17.
doi: 10.3748/wjg.v19.i29.4808.

FDG-PET in diagnosis, staging and prognosis of pancreatic carcinoma: a meta-analysis

Zhen Wang  1 , Jun-Qiang Chen, Jin-Lu Liu, Xin-Gan Qin, Yuan Huang
Affiliations
Meta-Analysis

FDG-PET in diagnosis, staging and prognosis of pancreatic carcinoma: a meta-analysis

Zhen Wang et al. World J Gastroenterol. .

Abstract

Aim: To investigate the potential role of positron emission tomography (PET) in the diagnosis, staging and prognosis predicting of pancreatic carcinoma (PC).

Methods: A systematic review of relevant literatures in PubMed, Embase and Cochrane Library was performed. The sensitivity and specificity of diagnostic and staging studies, and HRs for prognosis predicting studies were pooled. The bivariate model was used for diagnostic studies and the random-effect model for prognostic studies. Heterogeneity between included studies was tested using χ(2) test, and subgroup analysis was performed to explain the heterogeneities. All of the calculations were performed using Stata version 11.0.

Results: A total of 39 studies were included. The pooled sensitivity of PET in diagnosing PC (30 studies, 1582 patients), evaluating N stating (4 studies, 101 patients) and liver metastasis (7 studies, 316 patients) were 0.91 (95%CI: 0.88-0.93), 0.64 (95%CI: 0.50-0.76), and 0.67 (95%CI: 0.52-0.79), respectively; and the corresponding specificity was 0.81 (95%CI: 0.75-0.85), 0.81 (95%CI: 0.25-0.85), and 0.96 (95%CI: 0.89-0.98), respectively. In prognosis analysis (6 studies, 198 patients), significant difference of overall survival was observed between high and low standardized uptake value groups (HR = 2.39, 95%CI: 1.57-3.63). Subgroup analysis showed that PET/CT was more sensitive than PET alone in evaluating liver metastasis of PC, 0.82 (95%CI: 0.48-0.98) and 0.67 (95%CI: 0.52-0.79), respectively.

Conclusion: PET can be used as a valuable diagnostic and predictive tool for PC, but its effect in the staging of PC remains indeterminate.

Keywords: Diagnosis; Meta-analysis; Pancreatic carcinoma; Positron emission tomography; Prognosis; Staging.

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Figures

Figure 1
Figure 1
QUORUM flow chart for studies.
Figure 2
Figure 2
Methodological quality graph. A: Diagnosis and staging studies; B: Prognosis studies. Authors’ judgments about each methodological quality item presented as percentages across all included studies.
Figure 3
Figure 3
Forrest plot for the prognosis of pancreatic carcinoma. 1Patients received operation; 2Patients did not receive operation.
Figure 4
Figure 4
Hierarchical summary receiver operating characteristic curve. A: For the diagnosis of pancreatic carcinoma; B: For N staging of pancreatic carcinoma; C: For liver metastasis of pancreatic carcinoma. HSROC: Hierarchical summary receiver operating characteristic.
Figure 5
Figure 5
Funnel plot based on the data of positron emission tomography/ computed tomography for the diagnosis of pancreatic carcinoma.
See this image and copyright information in PMC

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