Role of 18F-Fluorodeoxyglucose Positron Emission Tomography or Positron Emission Tomography/Computed Tomography for the Detection of Recurrent Disease after Treatment of Malignant Melanoma

Abstract

Background: The purpose of the current study was to investigate the diagnostic performance of ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET) or PET/computed tomography (PET/CT) for the detection of recurrent disease after treatment of malignant melanoma (MM) through a systematic review and meta-analysis. Methods: The PubMed and EMBASE databases, from the earliest available date of indexing through December 31, 2018, were searched for studies evaluating the diagnostic performance of ¹⁸F-FDG-PET or PET/CT for the detection of recurrent disease after treatment of MM. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR–), and constructed summary receiver operating characteristic (SROC) curves. Results: Across 14 results from 11 studies, the pooled sensi­tivity for ¹⁸F-FDG-PET or PET/CT was 0.94 (95% confidence interval [CI] 0.90–0.97) with heterogeneity (I² = 57.95) and a pooled specificity of 0.91 (95% CI 0.88–0.93) without heterogeneity (I² = 27.24). LR syntheses gave an overall LR+ of 10.4 (95% CI 7.7–14.2) and an LR– of 0.06 (95% CI 0.04–0.11). The pooled diagnostic odds ratio was 162 (95% CI 94–280). The hierarchical SROC curve indicated that the area under the curve was 0.96 (95% CI 0.93–0.97). In meta-regression analysis, no definite variable was the source of the study heterogeneity. Conclusion: The current meta-analysis showed a high sensitivity and specificity of ¹⁸F-FDG-PET or PET/CT for the detection of recurrent disease after treatment of MM. The LR scattergram indicated that ¹⁸F-FDG-PET or PET/CT is useful for exclusion and confirmation of recurrent disease after treatment of MM.