18FDG-PET/CT for the detection of regional nodal metastasis in patients with head and neck cancer: A meta-analysis

SummaryWe performed a meta-analysis to evaluate the role of 18FDG-PET/CT for detection of regional nodal metastasis in patients with head and neck cancer (HNC). Studies about 18FDG-PET/CT were systematically searched in the MEDLINE and EMBASE databases. The Stata software was used to obtain pooled estimates of sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for 18FDG-PET/CT. We also compared the performance of 18FDG-PET/CT with that of conventional imaging (CT, MRI, and CT/MRI) by analyzing studies that had also used conventional imaging on the same patients. 24 articles bulled all inclusion criteria (1270 patients). The pooled per-patient, per-neck-side, and per-neck-level sensitivities/specificities for 18FDG-PET/CT were 0.91/0.87, 0.84/0.83, and 0.80/0.96, respectively. Across 13 studies (3460 neck levels) with per-neck-level data, the sensitivity and specificity of PET-CT were 0.84 and 0.96, and of conventional imaging were 0.63 and 0.96, respectively. 18FDG-PET/CT has good diagnostic performance for the detection of regional nodal metastasis in HNC patients. Compared with conventional imaging, 18FDG-PET/CT may have higher per-neck-level sensitivity.