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. 2023 Feb 13:13:1114059.
doi: 10.3389/fonc.2023.1114059. eCollection 2023.

[18F]FDG PET/CT versus [18F]FDG PET/MRI for the diagnosis of colorectal liver metastasis: A systematic review and meta-analysis

Zhi Miao  1   2 , Xiaomeng Zhao  1   2 , Xuanwen Li  3
Affiliations

[18F]FDG PET/CT versus [18F]FDG PET/MRI for the diagnosis of colorectal liver metastasis: A systematic review and meta-analysis

Zhi Miao et al. Front Oncol. .

Abstract

Purpose: The purpose of our meta-analysis and systematic review was to compare the diagnostic performance of [18F]FDG PET/CT and [18F]FDG PET/MRI in colorectal liver metastasis.

Methods: We searched PubMed, Embase, and Web of Science for eligible articles until November 2022. Studies focusing on the diagnostic value of [18F]FDG PET/CT or PET/MRI for colorectal liver metastasis were included. Using a bivariate random-effect model, the pooled sensitivity and specificity for [18F]FDG PET/CT and [18F]FDG PET/MRI were reported as estimates with 95% confidence intervals (CIs). Heterogeneity among pooled studies was assessed using the I2 statistic. The Quality Assessment of Diagnostic Performance Studies (QUADAS-2) method was used to evaluate the quality of the studies that were included.

Results: There were a total of 2743 publications identified in the initial search, finally, a total of 21 studies comprising 1036 patients were included. The pooled sensitivity, specificity, and AUC of [18F]FDG PET/CT in were 0.86 (95% CI: 0.76-0.92), 0.89 (95% CI: 0.83-0.94), and 0.92(95% CI: 0.90-0.94). [18F]FDG PET/MRI were 0.84 (95% CI: 0.77-0.89), 1.00 (95% CI: 0.32-1.00), and 0.89(95% CI: 0.86-0.92), respectively.

Conclusion: [18F]FDG PET/CT shows similar performance compared to [18F]FDG PET/MRI in detecting colorectal liver metastasis. However, pathological results were not obtained for all patients in the included studies and PET/MRI results were derived from studies with small sample sizes. There is a need for additional, larger prospective studies on this issue.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier (CRD42023390949).

Keywords: PET/CT; PET/MRI; colorectal neoplasms; liver metastasis; meta-analysis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The PRISMA flow chart of study selection process.
Figure 2
Figure 2
Graph of risk of bias and applicability of all eligible studies based on QUADAS-2 tool.
Figure 3
Figure 3
Forest plots of the combined [18F]FDG PET/CT sensitivity and specificity for colorectal liver metastasis. Squares denoted the sensitivity and specificity in each study, while horizontal bars indicated the 95% confidence interval.
Figure 4
Figure 4
Forest plots of the combined [18F]FDG PET/MRI sensitivity and specificity for colorectal liver metastasis. Squares denoted the sensitivity and specificity in each study, while horizontal bars indicated the 95% confidence interval.
Figure 5
Figure 5
[18F]FDG PET/CT and [18F]FDG PET/MRI summary receiver operating characteristic (SROC) curves. The summary point is the optimal combination of sensitivity and specificity. The black dotted lines surrounding each summary point indicates the 95% confidence interval.
Figure 6
Figure 6
Forest plots of the combined [18F]FDG PET/CT sensitivity and specificity in patient-based analysis for colorectal liver metastasis. Squares denoted the sensitivity and specificity in each study, while horizontal bars indicated the 95% confidence interval.
Figure 7
Figure 7
Multiple univariable meta-regression forest plot of [18F]FDG PET/CT for colorectal liver metastasis.
Figure 8
Figure 8
Deek’s funnel plot was used to evaluate the publication bias of [18F]FDG PET/CT and [18F]FDG PET/MRI. (A) Deek's funnel plot for PET/CT; (B) Deek's funnel plot for PET/CT. P<0.05 was considered significant.
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