Abstract
Purpose
To perform a systematic review to compare FDG-PET, CT, and MRI imaging for diagnosis
of local residual or recurrent nasopharyngeal carcinoma.
Materials and methods
MEDLINE, EMBASE, the CBMdisc databases and some other databases were searched for
relevant original articles published from January 1990 to June 2007. Inclusion criteria
were as follows: Articles were reported in English or Chinese; FDG-PET, CT, or MRI
was used to detect local residual or recurrent nasopharyngeal carcinoma; histopathologic
analysis and/or close clinical and imaging follow-up for at least 6 months were the reference standard. Two reviewers independently extracted data. A
software called “Meta-DiSc” was used to obtain pooled estimates of sensitivity, specificity,
diagnostic odds ratio (DOR), summary receiver operating characteristic (SROC) curves,
and the Q∗ index.
Results
Twenty-one articles fulfilled all inclusion criteria. The pooled sensitivity estimates
for PET (95%) were significantly higher than CT (76%) (P < 0.001) and MRI (78%) (P < 0.001). The pooled specificity estimates for PET (90%) were significantly higher than
CT (59%) (P < 0.001) and MRI (76%) (P < 0.001). The pooled DOR estimates for PET (96.51) were significantly higher than CT
(7.01) (P < 0.001) and MRI (8.68) (P < 0.001). SROC curve for FDG-PET showed better diagnostic accuracy than CT and MRI.
The Q∗ index for PET (0.92) was significantly higher than CT (0.72) (P < 0.001) and MRI (0.76) (P < 0.01). For PET, the sensitivity and diagnostic OR for using qualitative analysis were
significantly higher than using both qualitative and quantitative analyses (P < 0.01). For CT, the sensitivity, specificity, diagnostic OR, and the Q∗ index for dual-section helical and multi-section helical were all significantly higher
than nonhelical and single-section helical (P < 0.01). And the sensitivity for ‘section thickness <5 mm’ was significantly lower than ‘=5 mm’ (P < 0.01), while the specificity was significantly higher (P < 0.01). For MRI, there were no significant differences found between magnetic field
strength <1.5 and ⩾1.5 T (P > 0.05).
Conclusion
FDG-PET was the best modality for diagnosis of local residual or recurrent nasopharyngeal
carcinoma. The type of analysis for PET imaging and the section thickness for CT would
affect the diagnostic results. Dual-section helical and multi-section helical CT were
better than nonhelical and single-section helical CT.
Keywords
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Article info
Publication history
Published online: November 26, 2007
Accepted:
November 3,
2007
Received in revised form:
November 2,
2007
Received:
September 10,
2007
Identification
Copyright
© 2007 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
