18F-fluorodeoxyglucose positron emission tomography-computed tomography as a diagnostic tool in patients with cervical nodal metastases of unknown primary site: a meta-analysis

Background: We performed a meta-analysis to evaluate the value of (18)F-fluorodeoxyglucose positron emission tomography-computed tomography ((18)FDG PET-CT) for the detection of primary sites in patients with cervical nodal metastases of unknown origin.

Methods: Studies were systematically searched for relevant PET-CT original articles in the MEDLINE and EMBASE databases. We calculated the primary tumor detection rate, sensitivity, specificity, and likelihood ratios for (18)FDG PET-CT. We also constructed the hierarchic summary receiver operating characteristic curve for (18)FDG PET-CT.

Results: This present study analyzed a total of 7 selected studies (246 patients). The primary tumor detection rate, sensitivity and specificity of PET-CT were 0.44 (95% confidence interval [CI] = 0.31-0.58), 0.97 (95% CI = 0.63-0.99), and 0.68 (95% CI = 0.49-0.83). Area under the curve was 0.83 (95% CI = 0.80-0.86).

Conclusions: (18)FDG PET-CT has high sensitivity and low specificity for the detection of primary sites in patients with cervical nodal metastases of unknown origin.