18F-FDG PET and 18F-FDG PET/CT in Vulvar Cancer: A Systematic Review and Meta-analysis

Autor: Simona Maria Fragomeni, Giorgia Garganese, Elizabeth Katherine Anna Triumbari, Angela Collarino, Elizabeth J. de Koster, Vittoria Rufini
Rok vydání: 2020
Předmět:
medicine.medical_specialty
030218 nuclear medicine & medical imaging
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
0302 clinical medicine
systematic review
Fluorodeoxyglucose F18
Positron Emission Tomography Computed Tomography
Biopsy
medicine
Humans
F-18-FDG PET
Radiology
Nuclear Medicine and imaging
Prospective cohort study
Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA
Neoplasm Staging
Vulvar neoplasm
vulvar cancer
medicine.diagnostic_test
Vulvar Neoplasms
business.industry
General Medicine
Vulvar cancer
Sentinel node
medicine.disease
Confidence interval
meta-analysis
030220 oncology & carcinogenesis
Meta-analysis
Diagnostic odds ratio
Female
Radiology
business
Nanomedicine Radboud Institute for Molecular Life Sciences [Radboudumc 19]
CT
Zdroj: Clinical Nuclear Medicine, 46, 125-132
Clinical Nuclear Medicine, 46(2), 125-132. LIPPINCOTT WILLIAMS & WILKINS
Clinical Nuclear Medicine, 46, 2, pp. 125-132
ISSN: 1536-0229
0363-9762
Popis: Aim The aims of this study were to determine the role of 18F-FDG PET/CT in vulvar cancer patients and to extract summary estimates of its diagnostic performance for preoperative lymph node staging. Patients and methods PubMed/Medline and Embase databases were searched to identify studies evaluating 18F-FDG PET/CT in vulvar cancer patients. The assessment of methodological quality of the included articles was performed. Per-patient and per-groin pooled estimates, with 95% confidence intervals (CIs), of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic odds ratio (DOR) were calculated. Results Ten articles were included in the systematic review, 7 among which evaluated the diagnostic performance of preoperative 18F-FDG PET/CT for lymph node staging. Qualitative per-patient analysis (72 patients from 4 studies) resulted in estimated pooled sensitivity, specificity, PPV, NPV, and DOR of 0.70 (95% CI, 0.44-0.95), 0.90 (95% CI, 0.76-1.04), 0.86 (95% CI, 0.66-1.06), 0.77 (95% CI, 0.56-0.97), and 10.49 (95% CI, 1.68-65.50), respectively. Qualitative per-groin analysis (245 groins from 5 studies) resulted in estimated pooled sensitivity, specificity, PPV, NPV, and DOR of 0.76 (95% CI, 0.57-0.94), 0.88 (95% CI, 0.82-0.94), 0.70 (95% CI, 0.55-0.85), 0.92 (95% CI, 0.86-0.97), and 19.43 (95% CI, 6.40-58.95), respectively. Conclusions Despite limited literature data, this systematic review and meta-analysis revealed that a negative preoperative PET/CT scan may exclude groin metastases in at least early-stage vulvar cancer patients currently unfit for sentinel node biopsy and select those eligible for a less invasive surgical treatment. A positive PET/CT result should otherwise be interpreted with caution. Larger prospective studies are needed to confirm these results and to evaluate the diagnostic value of standardized semiquantitative analysis compared with the qualitative one.
Databáze: OpenAIRE
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