@article {Ioannidis717, author = {John P.A. Ioannidis and Joseph Lau}, title = {18F-FDG PET for the Diagnosis and Grading of Soft-Tissue Sarcoma: A Meta-Analysis }, volume = {44}, number = {5}, pages = {717--724}, year = {2003}, publisher = {Society of Nuclear Medicine}, abstract = {PET using 18F-FDG is increasingly used for the diagnosis and grading of tumors. Several studies have been performed that evaluate the diagnostic and grading performance of 18F-FDG PET for soft-tissue sarcoma, but each study has had a limited sample size. Therefore, we undertook a comprehensive meta-analysis of the evidence. Methods: Relevant studies were identified from MEDLINE and EMBASE. Diagnostic and grading performance were evaluated for qualitative visualization; standard uptake value (SUV, cutoffs of 2.0 and 3.0); and metabolic rate of glucose (MRG, cutoff of 6.0 μmol/100 g/min). Quantitative data synthesis included independent weighting of sensitivity and specificity, construction of summary receiver operating characteristic curves, and pooled analyses. Results: The meta-analysis included 15 studies with 441 soft-tissue lesions (227 malignant, 214 benign). For diagnosis of malignant versus benign lesions, typical pairs of sensitivity and specificity estimates from the summary receiver operating characteristic curves were 92\% and 73\% for qualitative visualization; 87\% and 79\% for SUV 2.0; 70\% and 87\% for SUV 3.0; and 74\% and 73\% for MRG 6.0. Diagnostic performance was similar for primary and recurrent lesions. By qualitative interpretation, 18F-FDG was positive in all intermediate/high-grade tumors (95\% confidence interval [CI], 97.3\%{\textendash}100\%), 74.4\% (95\% CI, 58.6\%{\textendash}85.9\%) of low-grade tumors, and 39.3\% (95\% CI, 29.1\%{\textendash}50.3\%) of benign lesions (including 11 of 12 inflammatory lesions). Using an SUV cutoff of 2.0, respective rates were 89.4\% (95\% CI, 79.4\%{\textendash}95.6\%), 33.1\% (95\% CI, 15.6\%{\textendash}55.3\%), and 19.1\% (95\% CI, 10.6\%{\textendash}30.5\%). Limited data on comparisons with MRI and CT showed no differences against 18F-FDG PET in diagnosing recurrent and metastatic disease. Conclusion: 18F-FDG PET has very good discriminating ability in the evaluation of both primary and recurrent soft-tissue lesions. 18F-FDG PET may be helpful in tumor grading but offers inadequate discrimination between low-grade tumors and benign lesions.}, issn = {0161-5505}, URL = {https://jnm.snmjournals.org/content/44/5/717}, eprint = {https://jnm.snmjournals.org/content/44/5/717.full.pdf}, journal = {Journal of Nuclear Medicine} }