Meta-analysis of 18FDG PET-CT for nodal staging in patients with esophageal cancer

Background: We aimed to evaluate the value of (18)FDG PET-CT for detection of regional nodal metastasis in patients with esophageal cancer before surgery. Methods: A computer search about PET-CT original articles was conducted from January 2000 to December 2012. The reference standard was histopathologic analysis. Two reviewers independently searched articles and extracted data. Sensitivity, specificity, diagnostic odds ratio, and likelihood ratio were pooled for PET-CT using bivariate models. Summary receiver operating characteristic (SROC) curves were also used to summarize overall test performance. Results: Across all seven studies on a per-station analysis (2232 stations), the pooled sensitivity and specificity with 95% confidence interval for PET-CT were 0.62 (0.40-0.79) and 0.96 (0.93-0.98). Across all 6 studies on a per-patient analysis (245 patients), corresponding values for PET-CT were 0.55 (0.34-0.74) and 0.76 (0.66-0.83). Conclusions: (18)FDG PET-CT had lower sensitivity and accuracy for detection of regional nodal metastasis in patients with esophageal cancer before surgery. (C) 2013 Elsevier Ltd. All rights reserved.