Meta-analysis of the additional value of integrated 18FDG PET-CT for tumor distant metastasis staging: comparison with 18FDG PET alone and CT alone.

Background: We performed a meta-analysis to compare the diagnostic performance of integrated (18)FDG PET-CT with that of (18)FDG PET alone and CT alone for the overall assessment of tumor distant metastases.

Methods: We performed a meta-analysis of 11 available articles (1107 patients). We calculated sensitivities, specificities, positive likelihood ratios, and negative likelihood ratios for integrated PET-CT, PET alone, and CT alone, respectively. We also constructed summary receiver operating characteristic curves for integrated PET-CT, PET alone, and CT alone, respectively.

Results: Across 10 comparative studies (1058 patients), integrated PET-CT has higher sensitivity (0.95 vs 0.85) and similar specificity (0.96 vs 0.95) with PET alone. Across 7 comparative studies (745 patients), integrated PET-CT has higher sensitivity (0.97 vs 0.80) and similar specificity (0.97 vs 0.94) with CT alone.

Conclusion: Integrated PET-CT is the most sensitive and accurate modality for tumor distant metastasis staging. Integrating PET with CT may tend to improve the sensitivity than PET alone and CT alone.