Usefulness of 18F-FDG PET, combined FDG-PET/CT and EUS in diagnosing primary pancreatic carcinoma: A meta-analysis

• Published in: European journal of radiology 2011-04, Vol.78 (1), p.142-150
• Main Authors: Tang, Shuang, Huang, Gang, Liu, Jianjun, Liu, Tao, Treven, Lyndal, Song, Saoli, Zhang, Chenpeng, Pan, Lingling, Zhang, Ting
• Format: Article
• Language: English
• Subjects: 18F-FDG PET; Biological and medical sciences; Diagnosis; Digestive system. Abdomen; Endoscopy; Endosonography - methods; EUS; Fluorodeoxyglucose F18; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Investigative techniques, diagnostic techniques (general aspects); Liver. Biliary tract. Portal circulation. Exocrine pancreas; Medical sciences; Meta-analysis; Pancreatic carcinoma; Pancreatic Neoplasms - diagnostic imaging; PET/CT; Positron-Emission Tomography - methods; Predictive Value of Tests; Radiopharmaceuticals; Sensitivity and Specificity; Tomography, X-Ray Computed - methods; Tumors
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2009.09.026

The aim was to evaluate the diagnostic value of 18F-fluorodeoxyglucose-positron emission tomography ( 18F-FDG PET), combined 18F-fluorodeoxyglucose-positron emission tomography/computed tomography ( 18F-FDG PET/CT) and endoscopic ultrasonography (EUS) in diagnosing patients with pancreatic carcinoma. MEDLINE, EMBASE, Cochrane library and some other databases, from January 1966 to April 2009, were searched for initial studies. All the studies published in English or Chinese relating to the diagnostic value of 18F-FDG PET, PET/CT and EUS for patients with pancreatic cancer were collected. Methodological quality was assessed. The statistic software called “Meta-Disc 1.4” was used for data analysis. Results: 51 studies were included in this meta-analysis. The pooled sensitivity estimate for combined PET/CT (90.1%) was significantly higher than PET (88.4%) and EUS (81.2%). The pooled specificity estimate for EUS (93.2%) was significantly higher than PET (83.1%) and PET/CT (80.1%). The pooled DOR estimate for EUS (49.774) was significantly higher than PET (32.778) and PET/CT (27.105). SROC curves for PET/CT and EUS showed a little better diagnostic accuracy than PET alone. For PET alone, when interpreted the results with knowledge of other imaging tests, its sensitivity (89.4%) and specificity (80.1%) were closer to PET/CT. For EUS, its diagnostic value decreased in differentiating pancreatic cancer for patients with chronic pancreatitis. In conclusion, PET/CT was a high sensitive and EUS was a high specific modality in diagnosing patients with pancreatic cancer. PET/CT and EUS could play different roles during different conditions in diagnosing pancreatic carcinoma.