Accuracy of 18F-flurodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in the staging of newly diagnosed nasopharyngeal carcinoma: a systematic review and meta- analysis

  • Balamurugan A Vellayappan National University Cancer Institute, National University Health System, National University of Singapore
  • Yu Yang Soon National University Cancer Institute, National University Health System, National University of Singapore
  • Arul Earnest Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School
  • Qing Zhang Department of Radiation Oncology, Sixth Hospital of Jiao Tong University, Shanghai, People's Republic of China
  • Wee Yao Koh National University Cancer Institute, National University Health System, National University of Singapore
  • Ivan Weng Keong Tham National University Cancer Institute, National University Health System, National University of Singapore
  • Khai Mun Lee National University Cancer Institute, National University Health System, National University of Singapore

Abstract

Background

The specific role of FDG-PET/CT in staging of nasopharyngeal carcinoma (NPC) remains to be validated. We performed a systematic review and meta-analysis to assess the accuracy of staging FDG-PET/CT for newly diagnosed NPC.

 

Methods

We searched various biomedical databases and conference proceedings for relevant studies. We determined the pooled sensitivities and specificities, diagnostic odds ratios (DOR) and constructed summary receiver operating characteristic (SROC) curves using the hierarchical regression model.

 

 

Results

We found 15 relevant studies including 851 patients. Five addressed primary tumor (T), nine addressed regional lymph nodes (N) and seven addressed distant metastasis (M). The combined sensitivity estimate for FDG-PET/CT in T classification was 0.77(95% confidence interval (CI) 0.59-0.95). For N classification, combined sensitivity was 0.84 (95% CI 0.76-0.91), specificity was 0.90(95% CI 0.83-0.97), DOR was 82.4 (23.2 to 292.6) and Q*-index was 0.90. For M classification, the combined sensitivity estimate was 0.87(95% CI 0.74-1.00), specificity was 0.98 (95% CI 0.96 – 1.00), DOR was 120.9 (43.0 to 340.0) and Q*-index was 0.89.

 

Conclusion

 

FDG-PET/CT showed good accuracy in N and M but not T classification for newly diagnosed NPC. FDG-PET/CT, together with Magnetic resonance imaging (MRI) of the nasopharynx, should be part of the routine staging investigations.

WebRepcurrentVotenoRatingnoWeight

Author Biographies

Balamurugan A Vellayappan, National University Cancer Institute, National University Health System, National University of Singapore
Registrar, Department of Radiation OncologyWebRepcurrentVotenoRatingnoWeight
Yu Yang Soon, National University Cancer Institute, National University Health System, National University of Singapore
Medical Officer, Department of Radiation OncologyWebRepcurrentVotenoRatingnoWeight
Arul Earnest, Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School
Associate Professor and Centre Director,Centre for Quantitative MedicineWebRepcurrentVotenoRatingnoWeight
Qing Zhang, Department of Radiation Oncology, Sixth Hospital of Jiao Tong University, Shanghai, People's Republic of China
Consultant, Department of Radiation OncologyWebRepcurrentVotenoRatingnoWeight
Wee Yao Koh, National University Cancer Institute, National University Health System, National University of Singapore
Consultant, Department of radiation oncologyWebRepcurrentVotenoRatingnoWeight
Ivan Weng Keong Tham, National University Cancer Institute, National University Health System, National University of Singapore
Senior Consultant, Department of Radiation OncologyWebRepcurrentVotenoRatingnoWeight
Khai Mun Lee, National University Cancer Institute, National University Health System, National University of Singapore
Senior Consultant, Department of Radiation OncologyWebRepcurrentVotenoRatingnoWeight
Published
2014-10-26
How to Cite
Vellayappan, B. A., Soon, Y. Y., Earnest, A., Zhang, Q., Koh, W. Y., Tham, I. W. K., & Lee, K. M. (2014). Accuracy of 18F-flurodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in the staging of newly diagnosed nasopharyngeal carcinoma: a systematic review and meta- analysis. Radiology and Oncology, 48(4). Retrieved from https://www.radioloncol.com/index.php/ro/article/view/2026
Section
Clinical oncology