Studies Evaluating 18F-FDG PET/CT for Restaging
| Results | |||||||||
| Study | Year | Type of study | No. of patients | Patient recruitment | Other diagnostic modalities | Diagnostic performance* | Management impact† | Prognosis | Conclusion |
| Radan et al. (23) | 2006 | R | 46 | Suspected recurrence on basis of rising tumor marker levels | ceCT (n = 37) | PET/CT: 27 TP (24 distant, 3 locoregional), 5 FP; Se = 90, Sp = 71, Acc = 83 | 51 | PET/CT had high performance indices and was superior to ceCT for diagnosis of recurrence | |
| ceCT: Se = 70, Sp = 47, Acc = 59 | |||||||||
| Schmidt et al. (26) | 2008 | R | 33 | Suspected recurrence on basis of clinical (n = 9) or imaging (n = 14) findings or rising tumor marker levels (n = 10) | WB MRI 1.5 T (n = 23) or 3 T (n = 10) | PET/CT: Se = 91, Sp = 90, Acc = 91 | PET/CT was superior for locoregional recurrence detection, whereas WB MRI showed excellent performance for detection of distant lesions | ||
| WB MRI: Se = 93, Sp = 86, Acc = 91 | |||||||||
| Aukema et al. (28) | 2010 | R | 56 | Confirmed locoregional recurrence | Chest MRI, CT, or radiography; liver US; bone scanning | PET/CT: Se = 97, Sp = 92, Acc = 95 | 48 | PET/CT played important role in staging for patients with locoregional recurrence, in addition to CIT | |
| PET/CT revealed additional lesions in 32 patients (57%) that were not visible on CIT in 25 patients (45%) | |||||||||
| Evangelista et al. (30) | 2011 | R | 111 | Suspected recurrence on basis of clinical (n = 26) or imaging (n = 85) findings | CT, CA 15.3 | PET/CT: Se = 81, Sp = 52, Acc = 60 | 56 | PET/CT was independent predictor of disease relapse | PET/CT was more sensitive than CT and CA 15.3 for evaluation of disease relapse |
| CT: Se = 72, Sp = 37, Acc = 47 | |||||||||
| CA 15.3: Se = 50, Sp = 69, Acc = 64 | |||||||||
| Champion et al. (31) | 2011 | R | 228 | Suspected recurrence on basis of rising tumor marker levels | Chest radiography, abdominopelvic US, bone scanning (n = 67) | PET/CT: Se = 94, Sp = 85, Acc = 92 | 54 | PET/CT was more sensitive than CIT for detection of recurrence in patients with rising tumor marker levels | |
| CIT: Se = 33, Sp = 100, Acc = 48 | |||||||||
| Chang et al. (33) | 2014 | R | 140 | Suspected recurrence (n = 71) or routine follow-up (n = 69) | For suspected recurrence: Se = 88, Sp = 87, Acc = 87 | 49 (suspected recurrence) | PET/CT was useful for early diagnosis of recurrence and might be useful for follow-up in asymptomatic patients | ||
| For routine follow-up: Se = 78, Sp = 92, Acc = 90 | 10 (follow-up) | ||||||||
| Cochet et al. (34) | 2014 | R | 63 | Suspected recurrence (n = 58) or routine follow-up (n = 5) | Chest CT or radiography; abdominopelvic MRI, CT, or US; bone scanning | PET/CT: NPV = 86, PPV = 95 | 57 | PET/CT predicted survival better than did CIT | PET/CT provided incremental information that influenced management and refined prognostic stratification |
| CIT: NPV = 54, PPV = 70 | |||||||||
| Di Gioia et al. (35) | 2015 | P | 44 | Suspected recurrence on basis of rising tumor marker levels | WB MRI 1.5 T (n = 43) | WB imaging (MRI or PET/CT) accurately detected metastases in 28 patients (64%), including 7 patients with oligometastatic disease, and secondary malignancy in 6 patients (14%) | Survival differed according to subtype | WB imaging was highly effective for early detection of recurrence in asymptomatic patients with confirmed rise in tumor marker levels | |
↵* Reported as percentages for sensitivity (Se), specificity (Sp), accuracy (Acc), negative predictive value (NPV), and positive predictive value (PPV).
↵† Reported as percentages of patients for whom findings had impact on management.
R = retrospective; ceCT = contrast-enhanced CT; TP = true-positive; FP = false-positive; US = ultrasonography; CIT = conventional imaging techniques; CA 15.3 = carcinoma antigen 15.3; P = prospective.