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Crump Institute for Biological Imaging
Department of Molecular and Medical Pharmacology, Division of Nuclear Medicine
Department of Biomathematics, University of California, Los Angeles
School of Medicine, Los Angeles, California
Correspondence: For correspondence or reprints contact: Sanjiv S. Gambhir, MD, PhD, Crump Institute for Biological Imaging, University of California, Los Angeles, School of Medicine, A-222B CIBI, 700 Westwood Plaza, Box 951770, Los Angeles, CA , 80095-1770.
ABSTRACT
A meta-analysis of the literature for the use of FDG PET in the detection of recurrent colorectal cancer (CRC) was conducted to evaluate the quality of the reported studies. Overall values for the sensitivity and specificity of whole-body FDG PET and an overall FDG PET-directed percentage change in management were also determined through this analysis. Methods: Guidelines to evaluate the articles were formulated on the basis of the U.S. medical payer source criteria for assessing studies that report information on usage of new medical technology. A meta-analysis was conducted using methodology described in the peer-reviewed literature. Results: On the basis of the guidelines established for our review, the availability of necessary information for assessing the reliability of the FDG PET data for diagnosing recurrent CRC was less than ideal. Through a meta-analysis of 11 articles, we determined, within a 95% confidence level, an overall sensitivity of 97% (95% confidence level, 95%–99%) and an overall specificity of 76% (95% confidence level, 64%–88%) for FDG PET detecting recurrent CRC throughout the whole body. Furthermore, through pooling of the change-in-management data, an overall FDG PET-directed change in management was calculated to be 29% (95% confidence level, 25%–34%). Conclusion: Our review suggests that improvements can be made to more effectively report the results of these FDG PET studies. The overall values determined through the meta-analysis indicate the potential benefits of using FDG PET as a diagnostic or management tool. Furthermore, these values should prove to be useful to assess the cost-effectiveness of using FDG PET in the management of patients with recurrent CRC.
Key Words: FDG PET • colorectal • cancer • meta-analysis • recurrent
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