PT  - JOURNAL ARTICLE
AU  - Nihashi, T.
AU  - Dahabreh, I.J.
AU  - Terasawa, T.
TI  - Diagnostic Accuracy of PET for Recurrent Glioma Diagnosis: A Meta-Analysis
AID  - 10.3174/ajnr.A3324
DP  - 2013 May 01
TA  - American Journal of Neuroradiology
PG  - 944--950
VI  - 34
IP  - 5
4099  - http://www.ajnr.org/content/34/5/944.short
4100  - http://www.ajnr.org/content/34/5/944.full
SO  - Am. J. Neuroradiol.2013 May 01; 34
AB  - BACKGROUND AND PURPOSE: Studies have assessed PET by using various tracers to diagnose disease recurrence in patients with previously treated glioma; however, the accuracy of these methods, particularly compared with alternative imaging modalities, remains unclear. We conducted a meta-analysis to quantitatively synthesize the diagnostic accuracy of PET and compare it with alternative imaging modalities. MATERIALS AND METHODS: We searched PubMed and Scopus (until June 2011), bibliographies, and review articles. Two reviewers extracted study characteristics, validity items, and quantitative data on diagnostic accuracy. We performed meta-analysis when ≥5 studies were available. RESULTS: Twenty-six studies were eligible. Studies were heterogeneous in treatment strategies and diagnostic criteria of PET; recurrence was typically suspected by CT or MR imaging. The diagnostic accuracies of 18F-FDG (n = 16) and 11C-MET PET (n = 7) were heterogeneous across studies. 18F-FDG PET had a summary sensitivity of 0.77 (95% CI, 0.66–0.85) and specificity of 0.78 (95% CI, 0.54–0.91) for any glioma histology; 11C-methionine PET had a summary sensitivity of 0.70 (95% CI, 0.50–0.84) and specificity of 0.93 (95% CI, 0.44–1.0) for high-grade glioma. These estimates were stable in subgroup and sensitivity analyses. Data were limited on 18F-FET (n = 4), 18F-FLT (n = 2), and 18F-boronophenylalanine (n = 1). Few studies performed direct comparisons between different PET tracers or between PET and other imaging modalities. CONCLUSIONS: 18F-FDG and 11C-MET PET appear to have moderately good accuracy as add-on tests for diagnosing recurrent glioma suspected by CT or MR imaging. Studies comparing alternative tracers or PET versus other imaging modalities are scarce. Prospective studies performing head-to-head comparisons between alternative imaging modalities are needed. CIconfidence interval11C-MET11-carbon methionine18F-FET18-fluorine fluoroethyltyrosine18F-FLT18-fluorine fluorothymidineROCreceiver operating characteristic201TIthallium 201