Diagnostic value of using 18F-FDG PET and PET/CT in immunocompetent patients with primary central nervous system lymphoma: A systematic review and meta-analysis
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Yaru Zou1,*, Jianjing Tong2,*, Haiyan Leng3, Jingwei Jiang4, Meng Pan1,* and Zi Chen5,3,*
1Department of Dermatology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
2Exclusive Medical Care Center, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
3Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China
4Department of Oncology, Huashan Hospital, Fudan University, Shanghai 200040, China
5Quintiles Asia Medical Oncology, Shanghai 200032, China
*These authors contributed equally to this work
Zi Chen, email: firstname.lastname@example.org
Meng Pan, email: email@example.com
Keywords: 18F-fluorodeoxyglucose, positron emission tomography, positron emission tomography/computed tomography, primary central nervous system lymphoma, diagnosis
Received: November 02, 2016 Accepted: April 12, 2017 Published: April 27, 2017
Background: 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and PET/CT have become two of the most powerful tools for malignant lymphoma exploration, but their diagnostic role in primary central nervous system lymphoma (PCNSL) is still disputed. The purpose of our study is to identify the usefulness of 18F-FDG PET and PET/CT for detecting PCNSL.
Results: A total of 129 patients, obtained from eight eligible studies, were included for this systematic review and meta-analysis. The performance of 18F-FDG PET and PET/CT for diagnosing PCNSL were as follows: the pooled sensitivity was 0.88 (95% CI: 0.80–0.94), specificity was 0.86 (95% CI: 0.73–0.94), positive likelihood ratio (PLR) was 3.99 (95% CI: 2.31–6.90), negative likelihood ratio (NLR) was 0.11 (95% CI: 0.04-0.32), and diagnostic odds ratio (DOR) was 33.40 (95% CI: 10.40–107.3). In addition, the area under the curve (AUC) and Q index were 0.9192 and 0.8525, respectively.
Materials and Methods: PubMed/MEDLINE, Embase and Cochrane Library were systematically searched for potential publications (last updated on July 16th, 2016). Reference lists of included articles were also checked. Original articles that reported data on patients who were suspected of having PCNSL were considered suitable for inclusion. The sensitivities and specificities of 18F-FDG PET and PET/CT in each study were evaluated. The Stata software and Meta-Disc software were employed in the process of data analysis.
Conclusions: 18F-FDG PET and PET/CT showed considerable accuracy in identifying PCNSL in immunocompetent patients and could be a valuable radiological diagnostic tool for PCNSL.
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