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. 2017 Sep 19;8(48):84473-84488.
doi: 10.18632/oncotarget.21055. eCollection 2017 Oct 13.

Comparison of DWI and 18F-FDG PET/CT for assessing preoperative N-staging in gastric cancer: evidence from a meta-analysis

Mingxu Luo  1 , Hongmei Song  2 , Gang Liu  1 , Yikai Lin  3 , Lintao Luo  1 , Xin Zhou  1 , Bo Chen  1   4
Affiliations

Comparison of DWI and 18F-FDG PET/CT for assessing preoperative N-staging in gastric cancer: evidence from a meta-analysis

Mingxu Luo et al. Oncotarget. .

Abstract

The diagnostic values of diffusion weighted imaging (DWI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for N-staging of gastric cancer (GC) were identified and compared. After a systematic search to identify relevant articles, meta-analysis was used to summarize the sensitivities, specificities, and areas under curves (AUCs) for DWI and PET/CT. To better understand the diagnostic utility of DWI and PET/CT for N-staging, the performance of multi-detector computed tomography (MDCT) was used as a reference. Fifteen studies were analyzed. The pooled sensitivity, specificity, and AUC with 95% confidence intervals of DWI were 0.79 (0.73-0.85), 0.69 (0.61-0.77), and 0.81 (0.77-0.84), respectively. For PET/CT, the corresponding values were 0.52 (0.39-0.64), 0.88 (0.61-0.97), and 0.66 (0.62-0.70), respectively. Comparison of the two techniques revealed DWI had higher sensitivity and AUC, but no difference in specificity. DWI exhibited higher sensitivity but lower specificity than MDCT, and 18F-FDG PET/CT had lower sensitivity and equivalent specificity. Overall, DWI performed better than 18F-FDG PET/CT for preoperative N-staging in GC. When the efficacy of MDCT was taken as a reference, DWI represented a complementary imaging technique, while 18F-FDG PET/CT had limited utility for preoperative N-staging.

Keywords: diffusion weighted imaging; gastric cancer; lymph node staging; positron emission tomography/computed tomography.

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Conflict of interest statement

CONFLICTS OF INTEREST None.

Figures

Figure 1
Figure 1. Flow diagram of literature search and study selection
Figure 2
Figure 2. Quality assessment of included studies using QUADAS-2
(A) For DWI studies; (B) For 18F-FDG PET/CT studies.
Figure 3
Figure 3. Forest plots of DWI and 18F-FDG PET/CT in evaluating preoperative N-staging in patients with gastric cancer
(A) Pooled sensitivity of DWI; (B) Pooled specificity of DWI; (C) Pooled sensitivity of 18F-FDG PET/CT; (D) Pooled specificity of 18F-FDG PET/CT.
Figure 4
Figure 4. The summary ROC curves of DWI and 18F-FDG PET/CT in evaluating preoperative N-staging in patients with gastric cancer
(A) For DWI; (B) For 18F-FDG PET/CT .
Figure 5
Figure 5. Univariable meta-regression & subgroups analyses of diagnostic performance of 18F-FDG PET/CT
(Abbreviations: GE = American General Corporation; QL = qualitative analysis; QN = quantitative analysis).
Figure 6
Figure 6. Deeks’ funnel plot asymmetry tests for assessing potential publication bias
(A) For DWI; (B) For 18F-FDG PET/CT.
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin. 2017;67:7–30. https://doi.org/10.3322/caac.21387. - DOI - PubMed
    1. de Martel C, Forman D, Plummer M. Gastric cancer: epidemiology and risk factors. Gastroenterol Clin North Am. 2013;42:219–240. https://doi.org/10.1016/j.gtc.2013.01.003. - DOI - PubMed
    1. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver 4) Gastric Cancer. 2017;20:1–19. https://doi.org/10.1007/s10120-016-0622-4. - DOI - PMC - PubMed
    1. Ono H, Yao K, Fujishiro M, Oda I, Nimura S, Yahagi N, Iishi H, Oka M, Ajioka Y, Ichinose M, Matsui T. Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer. Dig Endosc. 2016;28:3–15. https://doi.org/10.1111/den.12518. - DOI - PubMed
    1. Eom BW, Yu JS, Ryu KW, Kook MC, Kim YI, Cho SJ, Lee JY, Kim CG, Choi IJ, Yoon HM, Kim YW. Optimal submucosal invasion of early gastric cancer for endoscopic resection. Ann Surg Oncol. 2015;22:1806–1812. https://doi.org/10.1245/s10434-014-4308-z. - DOI - PubMed

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