The Diagnostic Performance of Maximum Uptake Value and Apparent Diffusion Coefficient in Differentiating Benign and Malignant Ovarian or Adnexal Masses: A Meta-Analysis.

Xianwen Hu,Zhigang Liang,Jiong Cai,Pan Wang,Guanlian Wang,Chuanqin Zhang

doi:10.3389/fonc.2022.840433

Xianwen Hu, Zhigang Liang + Show 4 more

Open Access

https://doi.org/10.3389/fonc.2022.840433

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Abstract

ObjectiveThe purpose of this meta-analysis was to provide evidence for using maximum uptake value (SUVmax) and apparent diffusion coefficient (ADC) to quantitatively differentiate benign and malignant ovarian or adnexal masses, and to indirectly compare their diagnostic performance.Material and MethodsThe association between SUVmax, ADC and ovarian or adnexal benign and malignant masses was searched in PubMed, Cochrane Library, and Embase databases until October 1, 2021. Two authors independently extracted the data. Studies included in the analysis were required to provide data for the construction of a 2 × 2 contingency table to evaluate the diagnostic performance of SUVmax or ADC in differentiating benign and malignant ovarian or adnexal masses. The quality of the enrolled studies was evaluated by Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) instrument, and the meta-analysis was conducted using Stata software version 14.0. Forest plots were generated according to the sensitivity and specificity of SUVmax and ADC, and meta-regression analysis was further used to assess heterogeneity between studies.ResultsA total of 14 studies were finally included in this meta-analysis by gradually excluding duplicate literatures, conference abstracts, guidelines, reviews, case reports, animal studies and so on. The pooled sensitivity and specificity of SUVmax for quantitative differentiation of benign and malignant ovarian or adnexal masses were 0.88 and 0.89, respectively, and the pooled sensitivity and specificity for ADC were 0.87 and 0.80, respectively.ConclusionQuantitative SUVmax and ADC values have good diagnostic performance in differentiating benign and malignant ovarian or adnexal masses, and SUVmax has higher accuracy than ADC. Future prospective studies with large sample sizes are needed for the analysis of the role of SUVmax and ADC in the differentiation of benign and malignant ovarian or adnexal masses.

Highlights

Ovarian cancer is one of the most common and deadly malignant tumors of the female reproductive tract
Previous meta-analyses have shown that Positron emission tomography (PET)/Computed tomography (CT) has a high accuracy in differentiating ovarian or adnexal benign and malignant tumors [9]
In order to solve this problem, this study conducted a meta-analysis based on published high-quality studies to quantitatively evaluate the diagnostic performance of maximum uptake value (SUVmax) of 18F-FDG PET/CT and apparent diffusion coefficient (ADC) values of diffusion weighted imaging (DWI)-magnetic resonance imaging (MRI) in differentiating benign and malignant ovarian tumors

Summary

Introduction

Ovarian cancer is one of the most common and deadly malignant tumors of the female reproductive tract. It is of great significance to find a highly sensitive and specific diagnostic method for correct diagnosis, clinical management, and prognosis evaluation of ovarian cancer. As a sequence of MRI, diffusion weighted imaging (DWI) has been proved to be of high diagnostic value in differentiating benign and malignant adnexal masses, especially entirely solid non-fatty, nonhemorrhagic masses, or complex masses that are either septated cysts or combined solid and cystic masses [7]. In order to solve this problem, this study conducted a meta-analysis based on published high-quality studies to quantitatively evaluate the diagnostic performance of maximum uptake value (SUVmax) of 18F-FDG PET/CT and apparent diffusion coefficient (ADC) values of DWI-MRI in differentiating benign and malignant ovarian tumors

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Conclusion