Prognostic significance of ¹⁸FDG PET/CT in patients with liver metastases: a meta-analysis

Objectives The role of 18-fluorodeoxyglucose positron emission tomography CT (¹⁸FDG PET/CT), as a prognostic factor for survival in patients with liver metastases, is still controversial. We sought to perform a meta-analysis of the literature to address this issue.

Methods A systematic literature search was performed to identify the studies that associated ¹⁸FDG PET/CT to clinical survival outcomes of patients with liver metastases. Methodological qualities of the included studies were also assessed. The summarized hazard ratio (HR) was estimated by using fixed- or random-effect model according to heterogeneity between trails.

Results By analyzing a total of 867 patients from 15 studies, we found that PET/CT for metabolic response to the therapy was capable of predicting event-free survival (EFS) and overall survival (OS) with statistical significance, and the HR was 0.38 (95% confidence interval [CI], 0.27-0.54) and 0.40 (95%CI, 0.21-0.76), respectively. Furthermore, pre-treatment ¹⁸FDG PET/CT with high standardized uptake value (SUV) was also significantly associated with poorer OS (HR, 1.12; 95%CI, 1.01-1.25). However, we did not find a statistically significant effect of post-treatment SUV for predicting OS (HR, 1.15; 95%CI, 0.96-1.37).

Conclusions The present meta-analysis confirms that ¹⁸FDG PET/CT is a useful tool to help predict survival outcomes in patients with liver metastases.

Research Support This study was partially financed by Founding of Shanghai Municipal Health Bureau (2012170); China Scholarship Council (201204490179) and the Education and Training Department of the Flemish Government (1F2B8G/JDW/2013-2014/13-BLT-CHI-02).