J Yeungnam Med Sci.  2023 Nov;40(Suppl):S37-S46. 10.12701/jyms.2023.00220.

Diagnostic performance of F-18 FDG PET or PET/CT for detection of recurrent gastric cancer: a systematic review and meta-analysis

• Choi CI
• Park JK
• Jeon TY
• Kim DH

• KMID: 2548341
• DOI: http://doi.org/10.12701/jyms.2023.00220

Abstract

Background
This systematic review and meta-analysis investigated the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) or PET/computed tomography (PET/CT) for the detection of disease recurrence after curative resection of gastric cancer.
Methods
The PubMed and Embase databases, from the earliest available date of indexing through November 30, 2019, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT to detect recurrent disease after gastric cancer surgery.
Results
Across 17 studies (1,732 patients), the pooled sensitivity for F-18 FDG PET or PET/CT was 0.82 (95% confidence interval [CI], 0.74–0.88) with heterogeneity of I2=76.5 (p<0.001), and the specificity was 0.86 (95% CI, 0.78–0.91) with heterogeneity of I2=94.2 (p<0.001). Likelihood ratio (LR) tests gave an overall positive LR of 6.0 (95% CI, 3.6–9.7) and negative LR of 0.2 (95% CI, 0.14–0.31). The pooled diagnostic odds ratio was 29 (95% CI, 13–63). The summary receiver operating characteristic curve indicates that the area under the curve was 0.91 (95% CI, 0.88–0.93).
Conclusion
The current meta-analysis showed good sensitivity and specificity of F-18 FDG PET or PET/CT for detecting recurrent disease after curative resection of gastric cancer despite heterogeneity in ethnicity, recurrence rate, histology, and interpretation method.

Keyword

Diagnostic imaging; Fluorodeoxyglucose F18; Gastric cancer; Positron emission tomography computed tomography; Recurrence

Figure

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  Fig. 1. Flowchart of the search for eligible studies on the diagnostic performance of F-18 FDG PET or PET/CT for detection of recurrent disease after curative resection of gastric cancer. FDG, fluorodeoxyglucose; PET, positron emission tomography; CT, computed tomography.

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  Fig. 2. Results of Deeks’ funnel plot of asymmetry test for publication bias. Non-significant slope indicates that no significant bias was found. ESS, effective sample size.

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  Fig. 3. Risk of bias and applicability concerns summary.

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  Fig. 4. Forest plot of pooled sensitivity and specificity of F-18 fluorodeoxyglucose positron emission tomography (PET) or PET/computed tomography for detection of disease recurrence after curative resection in patients with gastric cancer.

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  Fig. 5. The summary receiver operating characteristic (SROC) curves of F-18 fluorodeoxyglucose positron emission tomography (PET) or PET/computed tomography for detection of recurrent disease after curative resection of gastric cancer.

Reference

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