Objectives: Fluorine 18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) imaging has been used for staging of endometrial cancer. In the current study, we systematically searched the available literature on the accuracy of 18F-FDG PET imaging for staging of endometrial cancer.
Methods: PubMed, SCOPUS, ISI Web of Knowledge, Science Direct, and Springer were searched using “endometr* AND PET” as the search terms. All studies evaluating the accuracy of 18F-FDG PET in the staging of endometrial carcinoma were included. Statistical pooling of diagnostic accuracy indices was done using random-effects model. Cochrane Q test and I2 index were used for heterogeneity evaluation.
Results: Sixteen studies (807 patients in total) were included in the meta-analysis. Sensitivity and specificity for detection of the primary lesions were 81.8% (77.9%–85.3%) and 89.8% (79.2%–96.2%); for lymph node staging were 72.3% (63.8%–79.8%) and 92.9% (90.6%–94.8%); and for distant metastasis detection were 95.7% (85.5%–99.5%) and 95.4% (92.7%–97.3%).
Conclusions: Because of low sensitivity, diagnostic utility of 18F-FDG PET imaging is limited in primary tumor detection and lymph node staging of endometrial cancer patients. However, high specificities ensure high positive predictive values in these 2 indications. Diagnostic performance of 18F-FDG PET imaging is much better in detection of distant metastases. Larger studies with better design are needed to draw any more definite conclusion.
*Nuclear Medicine Research Center and †Women’s Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; and ‡Department of Nuclear Medicine and PET/CT Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
Address correspondence and reprint requests to Ramin Sadeghi, MD, Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. E-mail: firstname.lastname@example.org; email@example.com.
This study is the result of a residency thesis that was conducted in Women’s Health and Nuclear Medicine Research Centers of Mashhad University of Medical Sciences under the approval number 900786.
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The authors declare no conflicts of interest.
Received February 27, 2013
Accepted August 18, 2013