Diagnostic Accuracy of Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography in the Evaluation of the Primary Tumor in Patients with Cholangiocarcinoma: A Meta-Analysis

Abstract

Objective. To meta-analyze published data about the diagnostic accuracy of fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) or PET/computed tomography (PET/CT) for primary tumor evaluation in patients with cholangiocarcinoma (CCa). Methods. A comprehensive literature search of studies published through December 31, 2013, was performed. Pooled sensitivity and specificity were calculated on a per patient based analysis. Subgroup analyses considering the device used (PET versus PET/CT) and the localization of the primary tumor (intrahepatic cholangiocarcinoma (IH-CCa), extrahepatic cholangiocarcinoma (EH-CCa), and hilar cholangiocarcinoma (H-CCa)) were carried out. Results. Twenty-three studies including 1232 patients were included in the meta-analysis. Pooled sensitivity and specificity of 18F-FDG-PET or PET/CT were 81% and 82%, respectively. Pooled sensitivity and specificity, respectively, were 80% and 89% for PET, 82% and 75% for PET/CT, 95% and 83% for IH-CCa, 84% and 95% for H-CCa, and 76% and 74% for EH-CCa. Conclusions. 18F-FDG-PET and PET/CT were demonstrated to be accurate diagnostic imaging methods for primary tumor evaluation in patients with CCa. These tools have a better diagnostic accuracy in patients with IH-CCa than in patients with EH-CCa. Further studies are needed to evaluate the accuracy of 18F-FDG-PET or PET/CT in patients with H-CCa.

Preoperative Staging of Cholangiocarcinoma and Biliary Carcinoma using 18F-Fluorodeoxyglucose Positron Emission Tomography: A Meta-Analysis

“…However, one recent study showed PET/CT to be accurate in primary CCA evaluation, especially for intrahepatic compared with extrahepatic CCA,38 a finding that is similar to that of the current study.…”

Cholangiocarcinoma: Current Knowledge and New Developments

“…5). 36 18 F-FDG-positron emission tomography (PET) with CT (PET/CT) has a sensitivity and specificity of up to 95% and 83% in the evaluation of the primary tumor, but it does not provide a significant advantage over CT or MRI 37. Also, positive FDG-uptake can be observed in other malignancies (i.e., lymphomas), inflammatory and infectious processes.…”

Imaging of Cholangiocarcinoma

“…Regarding primary tumour detection in PET/CT, a meta-analysis of 1,232 patients in 23 studies provided high sensitivities of 95% and specificities of 83% for iCC [61], with a decrease to 84% and 76% in sensitivity and to 95% and 74% in specificity being found when evaluating pCC and eCC, respectively. This indicates a dependency of primary tumour evaluation on tumour localization.…”