Leiden University Scholarly Publications

Persistent URL of this record https://hdl.handle.net/1887/3277482

In Collections

This item can be found in the following collections:

Triumbari, E.K.A.; Koster, E.J. de; Rufini, V.; Fragomeni, S.M.; Garganese, G.; Collarino, A. (2021)

F-18-FDG PET and F-18-FDG PET/CT in Vulvar Cancer A Systematic Review and Meta-analysis

Article / Letter to editor
AimThe aims of this study were to determine the role of F-18-FDG PET/CT in vulvar cancer patients and to extract summary estimates of its diagnostic performance for preoperative lymph node staging. Patients and MethodsPubMed/Medline and Embase databases were searched to identify studies evaluating F-18-FDG PET/CT in vulvar cancer patients. The assessment of methodological quality of the included articles was performed. Per-patient and per-groin pooled estimates, with 95% confidence intervals (CIs), of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic odds ratio (DOR) were calculated. ResultsTen articles were included in the systematic review, 7 among which evaluated the diagnostic performance of preoperative F-18-FDG PET/CT for lymph node staging. Qualitative per-patient analysis (72 patients from 4 studies) resulted in estimated pooled sensitivity, specificity, PPV, NPV, and DOR of 0.70 (95% CI, 0.44-0.95), 0.90 (95% CI, 0.76...Show moreAimThe aims of this study were to determine the role of F-18-FDG PET/CT in vulvar cancer patients and to extract summary estimates of its diagnostic performance for preoperative lymph node staging. Patients and MethodsPubMed/Medline and Embase databases were searched to identify studies evaluating F-18-FDG PET/CT in vulvar cancer patients. The assessment of methodological quality of the included articles was performed. Per-patient and per-groin pooled estimates, with 95% confidence intervals (CIs), of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic odds ratio (DOR) were calculated. ResultsTen articles were included in the systematic review, 7 among which evaluated the diagnostic performance of preoperative F-18-FDG PET/CT for lymph node staging. Qualitative per-patient analysis (72 patients from 4 studies) resulted in estimated pooled sensitivity, specificity, PPV, NPV, and DOR of 0.70 (95% CI, 0.44-0.95), 0.90 (95% CI, 0.76-1.04), 0.86 (95% CI, 0.66-1.06), 0.77 (95% CI, 0.56-0.97), and 10.49 (95% CI, 1.68-65.50), respectively. Qualitative per-groin analysis (245 groins from 5 studies) resulted in estimated pooled sensitivity, specificity, PPV, NPV, and DOR of 0.76 (95% CI, 0.57-0.94), 0.88 (95% CI, 0.82-0.94), 0.70 (95% CI, 0.55-0.85), 0.92 (95% CI, 0.86-0.97), and 19.43 (95% CI, 6.40-58.95), respectively. ConclusionsDespite limited literature data, this systematic review and meta-analysis revealed that a negative preoperative PET/CT scan may exclude groin metastases in at least early-stage vulvar cancer patients currently unfit for sentinel node biopsy and select those eligible for a less invasive surgical treatment. A positive PET/CT result should otherwise be interpreted with caution. Larger prospective studies are needed to confirm these results and to evaluate the diagnostic value of standardized semiquantitative analysis compared with the qualitative one.Show less
F-18-FDG PET
CT
vulvar cancer
meta-analysis
systematic review
All authors
Triumbari, E.K.A.; Koster, E.J. de; Rufini, V.; Fragomeni, S.M.; Garganese, G.; Collarino, A.
Date
2021-02-01
Journal
Clinical Nuclear Medicine
Volume
46
Issue
2
Pages
125 - 132
DOI
doi:10.1097/RLU.0000000000003411