Abstract
Objective We sought to perform a systemic review and meta-analysis of the diagnostic performance of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (computed tomography) (PET(CT)) in detection of bone and/or bone marrow involvement (BMI) in pediatric neuroblastoma (NB). Materials and Methods We searched electronic databases Pubmed and Embase to retrieve relevant references. We calculated pooled sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR−), diagnostic odds ratio (DOR), and the area under the curve (AUC). Moreover, a summary receiver operating characteristic (SROC) curve and likelihood ratio dot plot were plotted. Study-between statistical heterogeneity was evaluated via I-square index (I2). Subgroup analyses were used to explore heterogeneity. Results Seven studies including 127 patients were involved in this meta-analysis. The overall sensitivity and specificity were 0.87 (95% CI: 0.65–0.96) with heterogeneity I2 = 88.1% (p < 0.001) and 0.96 (95% CI: 0.67–1.00) with heterogeneity I2 = 77.8% (p < 0.001), respectively. The pooled LR+, LR−, and DOR were 21.3 (95% CI: 2.1–213.9), 0.14 (95% CI: 0.05–0.40), and 157 (95% CI: 16–1532), respectively. The area under the SROC curve was 0.97 (95% CI: 0.95–0.98). Conclusions Through a meta-analysis, this study suggested that 18F-FDG PET(CT) has a good overall diagnostic accuracy in the detection of bone/BMI in pediatric neuroblastoma.
Highlights
Neuroblastoma (NB) is the most common extracranial pediatric malignancy, derived from the peripheral sympathetic nervous system [1]
Scattergram suggesting that 18F-FDG PET(CT
Metastatic bone-bone marrow is a sign of advanced disease
Summary
Neuroblastoma (NB) is the most common extracranial pediatric malignancy, derived from the peripheral sympathetic nervous system [1]. Previous meta-analysis suggested that 18F-FDG PET had a higher sensitivity but lower specificity than MIBG scintigraphy in NB lesion detection [8]. Another recent meta-analysis reported a 17% pooled sensitivity of positron emission tomography (computed tomography) (PET(CT)) for the detection of bone. E purpose of this meta-analysis is to meta-analyse the diagnostic performance of 18F-FDG PET(CT) in assessing bone/bone marrow involvement in pediatric NB patients to provide more evidence-based data for clinicians. Studies that met the following criteria were included in this analysis: (1) the main topic was the diagnostic accuracy of 18F-FDG PET(CT) in the detection of bone or bone marrow involvement in pediatric NB patients; (2) BMB as the gold standard; (3) sufficient data to reassess sensitivity and specificity. Values were considered statistically significant if the two-sided p value was
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