Diagnostic Accuracy of PET for Recurrent Glioma Diagnosis: A Meta-Analysis
Open Access
- 1 November 2012
- journal article
- research article
- Published by American Society of Neuroradiology (ASNR) in American Journal Of Neuroradiology
- Vol. 34 (5), 944-950
- https://doi.org/10.3174/ajnr.a3324
Abstract
BACKGROUND AND PURPOSE: Studies have assessed PET by using various tracers to diagnose disease recurrence in patients with previously treated glioma; however, the accuracy of these methods, particularly compared with alternative imaging modalities, remains unclear. We conducted a meta-analysis to quantitatively synthesize the diagnostic accuracy of PET and compare it with alternative imaging modalities. MATERIALS AND METHODS: We searched PubMed and Scopus (until June 2011), bibliographies, and review articles. Two reviewers extracted study characteristics, validity items, and quantitative data on diagnostic accuracy. We performed meta-analysis when ≥5 studies were available. RESULTS: Twenty-six studies were eligible. Studies were heterogeneous in treatment strategies and diagnostic criteria of PET; recurrence was typically suspected by CT or MR imaging. The diagnostic accuracies of 18F-FDG (n = 16) and 11C-MET PET (n = 7) were heterogeneous across studies. 18F-FDG PET had a summary sensitivity of 0.77 (95% CI, 0.66–0.85) and specificity of 0.78 (95% CI, 0.54–0.91) for any glioma histology; 11C-methionine PET had a summary sensitivity of 0.70 (95% CI, 0.50–0.84) and specificity of 0.93 (95% CI, 0.44–1.0) for high-grade glioma. These estimates were stable in subgroup and sensitivity analyses. Data were limited on 18F-FET (n = 4), 18F-FLT (n = 2), and 18F-boronophenylalanine (n = 1). Few studies performed direct comparisons between different PET tracers or between PET and other imaging modalities. CONCLUSIONS: 18F-FDG and 11C-MET PET appear to have moderately good accuracy as add-on tests for diagnosing recurrent glioma suspected by CT or MR imaging. Studies comparing alternative tracers or PET versus other imaging modalities are scarce. Prospective studies performing head-to-head comparisons between alternative imaging modalities are needed.This publication has 40 references indexed in Scilit:
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