Proportion of false-positive follow-up FDG-PET scans in lymphoma: Systematic review and meta-analysis

This study aimed to assess the false-positive proportion of follow-up 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in lymphoma patients who initially achieved an end-of-treatment complete remission, using biopsy as reference standard. Medline was searched for original studies,...

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Bibliographic Details
Published in:Critical reviews in oncology/hematology 2019-09, Vol.141, p.73-81
Main Authors: Adams, Hugo J.A., Kwee, Thomas C.
Format: Article
Language:English
Subjects:
Biopsy
Follow-up
Lymphoma
Meta-analysis
Positron emission tomography
Surveillance
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Summary:This study aimed to assess the false-positive proportion of follow-up 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in lymphoma patients who initially achieved an end-of-treatment complete remission, using biopsy as reference standard. Medline was searched for original studies, studies were methodologically evaluated and results were meta-analytically summarized. Proportion of false-positive results ranged between 9.5%–90.0%, with a weighted summary proportion (random effects) of 42.9% (95% confidence interval [CI]: 29.0%–58.0%). A separate subgroup analysis in symptomatic patients only again revealed a relatively high summary proportion of false-positive follow-up FDG-PET of 37.5% (random effects). In conclusion, the false-positive proportion of follow-up FDG-PET in lymphoma patients who initially achieved an end-of-treatment complete remission is high and remains high when a combination of clinical symptoms and follow-up FDG-PET is used. Therefore, biopsy remains compulsory and follow-up FDG-PET alone may be regarded as unreliable to define progression-free survival.
ISSN:1040-8428
1879-0461
DOI:10.1016/j.critrevonc.2019.05.010