Enhanced staging of extrahepatic hepatocellular carcinoma metastasis through dual-tracer PET/computed tomography: a systematic review and meta-analysis.
Nucl Med Commun
; 45(9): 758-769, 2024 Sep 01.
Article
en En
| MEDLINE
| ID: mdl-38899958
ABSTRACT
The aim of this study was to quantify the diagnostic value of dual-tracer PET/computed tomography (CT) with 11 C-acetate and fluorodeoxyglucose (FDG) in per-lesion and per-patient and its effect on clinical decision-making for choosing the most appropriate management. The study protocol is registered a priori at https//osf.io/rvm75/ . PubMed, Web of Science, Embase , and Cochrane Library were searched for relevant studies until 1 June 2023. Studies regarding the review question were included. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to assess bias risk. Per-lesion and per-patient diagnostic performance were calculated for (1) 11 C-acetate alone; (2) FDG alone; and (3) dual tracer of 11 C-acetate and FDG. A direct comparison of these three combinations was made. The possible sources of statistical heterogeneity were also examined. We also calculated the percentage change in clinical decision-making when dual-tracer PET/CT was added to conventional imaging routinely used for metastatic evaluation (CT/MRI). Grading of Recommendations, Assessment, Development, and Evaluations tool was used to evaluate the certainty of evidence. Eight studies including 521 patients and 672 metastatic lesions were included. Dual-tracer PET/CT had a per-lesion sensitivity of 96.3% [95% confidence interval (CI), 91.8-98.4%] and per-patient sensitivity of 95.5% (95% CI, 89.1-98.2%) which were highly superior to either of tracers alone. Per-patient specificity was 98.5% (84.1-99.9%) which was similar to either of tracers alone. Overall, 9.3% (95% CI, 4.7-13.9%) of the patients had their management beneficially altered by adding dual-tracer PET/CT to their conventional CT/MRI results. Dual-tracer PET/CT substantially outperforms single-tracer methods in detecting extrahepatic hepatocellular carcinoma metastases, evidencing its reliability and significant role in refining clinical management strategies based on robust diagnostic performance.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Carcinoma Hepatocelular
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Tomografía Computarizada por Tomografía de Emisión de Positrones
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Neoplasias Hepáticas
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Metástasis de la Neoplasia
Límite:
Humans
Idioma:
En
Revista:
Nucl Med Commun
Año:
2024
Tipo del documento:
Article
País de afiliación:
Irán
Pais de publicación:
Reino Unido