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Diagnostic performance of 18F-FDG PET or PET/CT in restaging renal cell carcinoma

a systematic review and meta-analysis

Ma, Huan; Shen, Guohua; Liu, Bin; Yang, Yuanyou; Ren, Pengwei; Kuang, Anren

Nuclear Medicine Communications: February 2017 - Volume 38 - Issue 2 - p 156–163
doi: 10.1097/MNM.0000000000000618

Background In recent years, fluorine-18-fluorodeoxyglucose (18F-FDG) PET or PET/computed tomography (PET/CT) has emerged as a valuable method for restaging of cancer. The aim of this study was to evaluate its diagnostic performance for detecting metastatic or recurrent lesions in patients with renal cell carcinoma (RCC).

Methods Several databases were searched for relevant articles on 18F-FDG PET or PET/CT for the restaging of RCC. Two researchers independently selected studies, extracted data, and assessed the methodological quality according to the QUADAS-2 tool. On a per-patient basis, we determined the pooled sensitivity, specificity, diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio. Summary receiver-operating characteristic curves were also constructed with the area under the curve and Q* index obtained.

Results A total of 15 studies involving 1168 patients fulfilled the inclusion criteria. After excluding one study on the basis of the sensitivity analysis, the pooled estimates of 14 studies were 0.86 [95% confidence interval (CI), 0.88–0.93] for sensitivity, 0.88 (95% CI, 0.84–0.91) for specificity, 5.85 (95% CI, 4.27–8.03) for positive likelihood ratio, 0.18 (95% CI, 0.12–0.26) for negative likelihood ratio, and 42.12 (95% CI, 21.56–82.28) for diagnostic odds ratio. The area under the curve and Q* estimates were 0.9310 and 0.8663, respectively.

Conclusions Current evidence suggests that 18F-FDG PET or PET/CT is a valuable tool in the detection of metastatic or recurrent lesions in patients with RCC. More prospective studies on PET or PET/CT in the restaging of RCC are still needed.

aKey Laboratory of Radiation Physics and Technology, Ministry of Education, Institute of Nuclear Science and Technology

Departments of bNuclear Medicine

cEvidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, China

* Huan Ma and Guohua Shen contributed equally to the writing of this article.

Correspondence to Anren Kuang, MD, Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, China Tel: +86 189 806 01582; fax:+86 28 854 22155; e-mail:

Received September 18, 2016

Received in revised form October 13, 2016

Accepted October 14, 2016

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