PET‐CT versus MRI in the diagnosis of lymph node metastasis of cervical cancer: A meta‐analysis

Abstract

To compare the clinical application value of positron emission tomography–computed tomography (PET‐CT) and magnetic resonance imaging (MRI) in the diagnosis of cervical cancer lymph node metastasis. We searched PubMed and other databases for the studies comparing the use of PET‐CT and MRI for the diagnosis of cervical cancer lymph node metastasis up to January 20, 2021. We strictly followed the inclusion and exclusion criteria to screen the literature and extract the data. Quality Assessment of Diagnostic Accuracy Studies (QUADAS)‐2 tool was used for quality evaluation of included studies, and Revman 5.3 and Stata 15.0 software were used for evaluating heterogeneity, synthesize sensitivity (SEN), specificity (SPE), positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and the area under the curve (AUC) and comparing the pretest and posttest probabilities. Finally, 11 studies were included for meta‐analysis. The synthesized results indicated that the SEN value of PET‐CT was 0.65 (0.60 ~ 0.69) and SPE was 0.93 (0.91 ~ 0.94), and the SEN value of MRI was 0.58 (0.54 ~ 0.63) and SPE was 0.91 (0.90 ~ 0.92). AUC of PET‐CT was 0.824, which was significantly higher than that of MRI (AUC = 0.702; p < .05). The subgroup analysis showed that the AUC value of the study based on study design and use of blinding methods was not statistically significant (all p > .05). There was no obvious publication bias in the synthesized analysis of the diagnostic value of PET‐CT and MRI (all p > .05). Highlights To compare positron emission tomography–computed tomography (PET‐CT) and magnetic resonance imaging (MRI) in diagnosis of cervical cancer lymph node metastasis. Synthesize sensitivity value of PET‐CT was comparable with that of MRI. Area under the curve of PET‐CT was significantly higher than that of MRI. There was no obvious publication bias in synthesized analysis.

Nodal Disease and Survival in Oral Cancer: Is Occult Metastasis a Burden Factor Compared to Preoperatively Nodal Positive Neck?

“…Sensitivities of 64% to 93% for presurgical magnetic resonance imaging (MRI) and of 66% to 85% for presurgical computed tomography (CT) have been reported in the detection of cervical lymph node metastasis [ 4 ]. Although, in a meta-analysis from Sun et al, 2022, better sensitivity and specificity was found for the MRI than the CT [ 5 ], other studies show similar sensitivity rates for both MRI and CT [ 6 ]. Relatively high sensitivity (75% to 90%) and specificity (94% to 99%) are reported in detecting lymph node metastases with 8F-fluorodeoxyglucose positron emission tomography (18FDG-PET) [ 7 ].…”

Prognostic value of 18F-FDG PET in uterine cervical cancer patients with stage IIICr allocated by imaging

“…In terms of PET, Sironi et al have reported that PET/CT provided sensitivity of 100% and speci city of 99.6% for the detection of lymph nodes metastases larger than even 0.5 cm in diameter 24 . A recent meta-analysis has shown that CT, MRI, and PET performed comparably for assessing nodal metastasis, with low sensitivity but high speci city 7 , although integrated PET/CT demonstrated higher sensitivity and comparable speci city to MRI and CT 6,25 . Moreover, the new PET modality of 18 F-FDG PET/MRI, which has the combined features of high softtissue contrast along with functional imaging of FDG uptake, may also have high diagnostic value in cervical cancer and potentially better diagnostic performance compared with the conventional imaging modalities of CT, MRI, and PET/CT 12,14 .…”

Prognostic value of 18F-FDG PET in uterine cervical cancer patients with stage IIICr allocated by imaging

“…In terms of 18 F-FDG PET, Sironi et al have reported that 18 F-FDG PET/CT provided sensitivity of 100% and specificity of 99.6% for the detection of lymph nodes metastases larger than even 0.5 cm in diameter 24 . A recent meta-analysis has shown that CT, MRI, and 18 F-FDG PET performed comparably for assessing nodal metastasis, with low sensitivity but high specificity 7 , although integrated 18 F-FDG PET/CT demonstrated higher sensitivity and comparable specificity to MRI and CT 6 , 25 . Moreover, the new PET modality of 18 F-FDG PET/MRI, which has the combined features of high soft-tissue contrast along with functional imaging of 18 F-FDG uptake, may also have high diagnostic value in cervical cancer and potentially better diagnostic performance compared with the conventional imaging modalities of CT, MRI, and 18 F-FDG PET/CT 12 , 14 .…”