Diagnostic accuracy of [18F]DOPA PET and PET/CT in patients with neuroendocrine tumors: a meta-analysis

Abstract

The aim of this study was to systematically review and meta-analyze published data on the diagnostic accuracy of positron emission tomography (PET) using fluorine-18-dihydroxyphenylalanine ([18F]DOPA) in patients with neuroendocrine tumors (NETs). A comprehensive computer literature search of the PubMed/MEDLINE, Embase and Scopus databases was conducted to identify studies on the use of [18F]DOPA PET or PET/computed tomography (PET/CT) in patients with proven or suspected NETs. Pooled sensitivity and specificity of [18F]DOPA PET and PET/CT on a per patient-based analysis were calculated. The area under the ROC curve was calculated to measure the accuracy of [18F]DOPA PET or PET/CT. Eight articles on gastroenteropancreatic and thoracic NETs, 13 on pheochromocytoma/paraganglioma (Pheo/PGL) and eight on recurrent medullary thyroid carcinoma (MTC) were included in our meta-analysis. The pooled sensitivity and specificity of [18F]DOPA PET or PET/CT in patients with thoracic and gastroenteropancreatic NETs were 77% (95% CI 71–82) and 95% (95% CI 87–98), respectively. The area under the ROC curve was 0.94. The pooled sensitivity and specificity of [18F]DOPA PET or PET/CT in patients with Pheo/PGL were 92% (95% CI 88–95) and 92% (95% CI 85–97), respectively. The area under the ROC curve was 0.95. The pooled sensitivity of [18F]DOPA PET or PET/CT in patients with recurrent MTC was 62% (95% CI 54–69). Heterogeneity was found between the studies with regard to the sensitivity of [18F]DOPA PET or PET/CT. Evidence-based data show that [18F]DOPA PET and PET/CT are accurate methods in patients with proven or suspected NETs. Large multicenter studies are necessary to substantiate the diagnostic accuracy of [18F]DOPA PET and PET/CT in this setting.