Diagnostic value of PET/CT versus PET/MRI in gynecological malignancies of the pelvis: A meta-analysis.

Abstract

PURPOSE\nTo perform a meta-analysis of the literature to compare the diagnostic performance of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) versus 18F-FDG positron emission tomography/magnetic resonance imaging (PET/MRI) for gynecological malignancies of the pelvis.\n\n\nMATERIALS AND METHODS\nWe searched for English-language studies, published through May 2019, on the diagnostic accuracy of PET/CT and PET/MRI for gynecological malignancies. To reduce inter-study heterogeneity, we focused primarily on studies in which both PET/CT and PET/MRI were performed on the entire study cohort. We pooled the sensitivity, specificity, diagnostic odds ratio, and area-under-the-receiver-operating-characteristic curve values for PET/CT and PET/MRI and determined the 95% confidence intervals (CIs).\n\n\nRESULTS\nOut of 30 studies, nine met the inclusion criteria. On patient-based analysis, PET/CT had a pooled sensitivity and specificity of 62.6% (95% CI: 47.1%-76%) and 91.6% (95% CI: 81.9%-96.3%), respectively, compared with 73.3% (95% CI: 63.1%-81.6%) (P\xa0=\xa00.22) and 91.2% (95% CI: 81.8%-96%) (P\xa0=\xa094) for PET/MRI. On lesion-based analysis, PET/CT had a pooled sensitivity and specificity of 81.5% (95% CI: 59.3%-93.1%) and 86.6% (95% CI: 77.3%-92.5%), respectively, compared with 84.7% (95% CI: 66.8%-93.8%) (P\xa0=\xa00.77) and 89.3% (95% CI: 85.2%-92.3%) (P\xa0=\xa00.51) for PET/MRI. The diagnostic odds ratios for PET/CT compared with PET/MRI were not significantly different in the patient-based (P\xa0=\xa00.48) and lesion-based analyses (P\xa0=\xa00.4).\n\n\nCONCLUSION\nCompared with PET/CT, PET/MRI had slightly better diagnostic performance to that of 18F-FDG PET/CT in the gynecological malignancies on lesion level (44 vs 26) and patient level analysis (28 vs 17). However, the differences between results showed no statistical significance (P\xa0=\xa00.4 and 0.48, respectively).