Performance of 18F-FDG-PET/CT as a next step in the search of occult primary tumors for patients with head and neck squamous cell carcinoma of unknown primary: a systematic review and meta-analysis
| Autor: | Gao Shi, Ji Bin, Shen Shurui, Huo Huasong |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry medicine.medical_treatment Interventional radiology medicine.disease Occult Head and neck squamous-cell carcinoma 030218 nuclear medicine & medical imaging Endoscopy Radiation therapy 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Sample size determination 030220 oncology & carcinogenesis Tonsil Meta-analysis medicine Radiology Nuclear Medicine and imaging Radiology business |
| Zdroj: | Clinical and Translational Imaging. 9:361-371 |
| ISSN: | 2281-7565 2281-5872 |
| Popis: | We performed a systemic review and meta-analysis to evaluate the performance of 18F-FDG-PET/CT as a next step in the search of occult primary tumors for patients with head and neck squamous cell carcinoma of unknown primary (HNSCC-UP). PubMed and Embase databases were searched from the earliest available date of indexing through February 2021. Eligible studies were those using 18F-FDG-PET/CT to detect occult primary tumors for HNSCC-UP, of which the defining diagnostic workup had been limited to endoscopy with or without CT/MRI. The detection rates were meta-analytically pooled using a random-effects model. Subgroup analyses and meta-regression were performed to explore the source of heterogeneity. A pooled analysis evaluating the false-positive proportions was also performed. Sixteen studies with 724 patients were included in this meta-analysis. The pooled detection rate was 40% (95% CI 31–49%), with high heterogeneity (I2 = 85.2%). No sources of heterogeneity were identified by analyzing multiple subgroups stratified by study design, sample size, ethnicity, use of contrast agent, defining diagnostic workup, image analysis, and reference standard (All P > 0.05). The most common sites of both true-positive cases and false-positive cases were tonsil and tongue base. The pooled false-positive proportion was 9% (95% CI 5–13%). 18F-FDG PET/CT is useful as a next step in the search of occult primary tumors in HNSCC-UP patients defined by endoscopy with or without CT/MRI. However, in light of the high false-positive proportion, confirmatory histological investigations should be viewed as necessary practice upon positive PET/CT findings. |
| Databáze: | OpenAIRE |
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