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. (c) 2013 Elsevier Ltd. All rights reserved.