Diagnostic accuracy of 18F-FDG PET/CT for detection of peritoneal carcinomatosis; a systematic review and meta-analysis.

Abstract

The current review aimed to investigate the performance of the diagnostic accuracy of 18F- fludeoxyglucose positron emission tomography/CT (PET/CT) in detecting peritoneal carcinomatosis (PC) through a systematic review and meta-analysis. The MEDLINE via PubMed and EMBASE from the earliest available date of indexing to 31 March 2017, were searched for studies evaluating the diagnostic performance of 18F-FDG PET/CT in detecting PC. We evaluated the pooled sensitivities and specificities across included studies, calculated positive and negative likelihood ratios (LR+ and LR-), and plotted summary receiver operating characteristic curves. Deek's funnel plot asymmetry tests were used to assess the possible underlying publication bias. The current meta-analysis demonstrated no significant publication bias (p = 0.21). Across 14 studies (671 patients), the overall sensitivity of 18F-FDG PET/CT was 0.87 [95% CI (0.77-0.93)] with heterogeneity (χ2 = 94.2, p = 0.00) and a pooled specificity of 0.92 [95% CI; (0.89-0.94)] with heterogeneity (χ2 = 20.6, p = 0.08). LR syntheses gave an overall LR+ of 10.4 [95% CI (7.5-14.5)] and LR- of 0.14 [95% CI (0.08-0.26)]. The pooled diagnostic odds ratio was 73 [95% CI (34-159)]. In univariate meta-regression analysis, publication year and cohort homogeneity were the potent sources of heterogeneity. However, in multivariate meta-regression, no definite variable was the source of the study heterogeneity. 18F-FDG PET/CT demonstrated good sensitivity and specificity for the detection of PC. Further large multicentre studies would be necessary to substantiate the diagnostic accuracy of 18F-FDG PET/CT for the diagnosis of PC in various cancers. Advances in knowledge: 18F-FDG PET/CT showed good diagnostic performance in the evaluation of PC and could provide additional information for that purpose in various cancers.