Meta-Analysis
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 7, 2013; 19(29): 4808-4817
Published online Aug 7, 2013. doi: 10.3748/wjg.v19.i29.4808
FDG-PET in diagnosis, staging and prognosis of pancreatic carcinoma: A meta-analysis
Zhen Wang, Jun-Qiang Chen, Jin-Lu Liu, Xin-Gan Qin, Yuan Huang
Zhen Wang, Jun-Qiang Chen, Jin-Lu Liu, Xin-Gan Qin, Yuan Huang, Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Author contributions: Wang Z, Chen JQ designed this study; Liu JL and Qin XG performed literature search; Liu JL and Huang Y extracted the data; Wang Z and Huang Y analyzed the data; Chen JQ and Qin XG interpreted the results; Wang Z drafted the manuscript; Chen JQ, Liu JL and Qin XG revised the paper; all authors read and approved the final manuscript to be published.
Supported by Grant from The Natural Science Foundation of Guangxi Zhuang Autonomous Region of China, No. 0832113 and 2012GXNSFDA239001; and the Research Project of Guangxi Education Department, No. 201012MS062
Correspondence to: Jun-Qiang Chen, MD, PhD, Professor, Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. gxhans@163.com
Telephone: +86-771-5356701 Fax: +86-771-5350031.
Received: March 6, 2013
Revised: May 2, 2013
Accepted: May 16, 2013
Published online: August 7, 2013
Processing time: 152 Days and 13.4 Hours
Abstract

AIM: To investigate the potential role of positron emission tomography (PET) in the diagnosis, staging and prognosis predicting of pancreatic carcinoma (PC).

METHODS: A systematic review of relevant literatures in PubMed, Embase and Cochrane Library was performed. The sensitivity and specificity of diagnostic and staging studies, and HRs for prognosis predicting studies were pooled. The bivariate model was used for diagnostic studies and the random-effect model for prognostic studies. Heterogeneity between included studies was tested using χ2 test, and subgroup analysis was performed to explain the heterogeneities. All of the calculations were performed using Stata version 11.0.

RESULTS: A total of 39 studies were included. The pooled sensitivity of PET in diagnosing PC (30 studies, 1582 patients), evaluating N stating (4 studies, 101 patients) and liver metastasis (7 studies, 316 patients) were 0.91 (95%CI: 0.88-0.93), 0.64 (95%CI: 0.50-0.76), and 0.67 (95%CI: 0.52-0.79), respectively; and the corresponding specificity was 0.81 (95%CI: 0.75-0.85), 0.81 (95%CI: 0.25-0.85), and 0.96 (95%CI: 0.89-0.98), respectively. In prognosis analysis (6 studies, 198 patients), significant difference of overall survival was observed between high and low standardized uptake value groups (HR = 2.39, 95%CI: 1.57-3.63). Subgroup analysis showed that PET/CT was more sensitive than PET alone in evaluating liver metastasis of PC, 0.82 (95%CI: 0.48-0.98) and 0.67 (95%CI: 0.52-0.79), respectively.

CONCLUSION: PET can be used as a valuable diagnostic and predictive tool for PC, but its effect in the staging of PC remains indeterminate.

Keywords: Pancreatic carcinoma; Positron emission tomography; Diagnosis; Staging; Prognosis; Meta-analysis

Core tip: Positron emission tomography (PET) is an important tool for the diagnosis, staging and prognosis predicting of tumors. However, no consensus has been reached with regard to the role of PET in pancreatic carcinoma (PC) diagnosis. We performed meta-analysis of 39 included studies. The pooled results showed that PET can be used as a valuable diagnostic and predictive tool for PC, but its effect in the staging remains indeterminate. New tracers and PET scanning technology, as well as other parameters besides of standardized uptake value should be noticed in order to improve the diagnostic and predictive accuracy of PET in PC.