530 False Positive Rate from Pet-Ct in Cutaneous Malignant Melanoma – a Systematic Review and Meta-Analysis

Abstract

Abstract Aim Cutaneous Malignant Melanoma (CMM) is increasing in incidence and is the leading cause of skin cancer mortality. Diagnosis involves primary excision followed by appropriate staging tests. Positron Emission Tomography combined with Computed Tomography (PET-CT) use has increased in recent years for clinical staging and detection of recurrence. False positive (FP) results are not uncommon and can have deleterious psychological, physical, and economic consequences. Few studies have quantified this. Thus, we present the first systematic review and meta-analysis of the pooled proportion of FP results in prospective studies of CMM and distribution of these by system. Method A systematic review and meta-analysis of FP results in prospective CMM PET-CT studies with distribution of FP results by body system. Results 14 studies were included with 851 patients. Primary reasons for exclusion were lack of FP reporting or studies being retrospective. Patient-based reporting had the lowest pooled proportion of 5.8% (95% CI = 3.5% to 8.6%), lesion-based was highest with 9.6% (95% CI = 3.1% to 19.1%) and combined was 6.9% (95% CI = 4.4% to 10.2%). Bias was low to unclear other than for FP reporting. Heterogeneity (I2) was considerable for all analyses. FP findings were mainly lymphatic, dermatological, respiratory, or skeletal. Conclusions Our data suggest that between 5.8% and 9.6% of PET-CT results are FPs; far higher than reported FP rates in current CMM literature. FP reporting was often inconsistent between studies and lacking in detail. Future work should include retrospective studies also and PET-CT research should consistently report FP results in more detail.