Impact on Patient Management of [18F]-Fluorodeoxyglucose-Positron Emission Tomography (PET) Used for Cancer Diagnosis: Analysis of Data From the National Oncologic PET Registry

Subramaniam, Rathan M.; Shields, Anthony F.; Sachedina, Archana; Hanna, Lucy; Duan, Fenghai; Siegel, Barry A.; Hillner, Bruce E.

doi:10.1634/theoncologist.2015-0364

Cited by 12 publications

(2 citation statements)

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“…They showed that the 18 F-FDG PET/CT results could add confidence to clinical likelihood in 28% of patients and correctly downgrade (16%) or upgrade (12%) the clinical score (5). A recent study by Subramaniam et al showed that 18 F-FDG PET has substantial impact in the management of patients with suspected paraneoplastic syndrome and those with cancer of unknown primary origin, resulting in change of the intended management in 25% and 43% of patients (40). Our meta-analysis showed that the diagnostic performance of 18 F-FDG PET/CT for the detection of underlying malignancy in patients with suspected paraneoplastic syndrome is comparable with its general performance in patients with cancer of unknown primary origin.…”

Section: Discussionmentioning

confidence: 99%

Whole-Body ¹⁸F-FDG PET and ¹⁸F-FDG PET/CT in Patients with Suspected Paraneoplastic Syndrome: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

et al. 2016

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The purpose of this study was to assess the diagnostic performance of whole-body 18 F-FDG PET or 18 F-FDG PET/CT for detection of underlying malignancy in patients with clinically suspected neurologic and nonneurologic paraneoplastic syndromes. Methods: A systematic search was performed in PubMed (Medline), Embase, and Scopus (last updated November 2016) to identify relevant published studies reporting the performance of 18 F-FDG PET or 18 F-FDG PET/CT in patients with suspected paraneoplastic syndrome. Histopathologic confirmation or clinical follow-up was considered as the reference standard. Pooled estimates, with 95% confidence intervals (CIs), of sensitivity, specificity, and diagnostic odds ratio were calculated. A summary receiver-operating-characteristic curve was constructed, and the area under the curve (AUC) was determined along with the Q* index. Results: Twenty-one studies including a total of 1,293 individual patients suspected of having a paraneoplastic syndrome and who underwent 18 F-FDG PET or 18 F-FDG PET/CT examinations met our inclusion criteria. There was moderate to high heterogeneity among the included studies. The pooled sensitivity, specificity, and diagnostic odds ratio of 18 F-FDG PET or 18 F-FDG PET/CT for the detection of underlying malignancy were 0.81 (95% CI, 0.76-0.86), 0.88 (95% CI, 0.86-0.90), and 34.03 (95% CI, 18.76-61.72), respectively. The AUC and the Q* index were 0.916 (SE, 0.018) and 0.849, indicating excellent diagnostic accuracy. The diagnostic accuracy was slightly improved after studies with high applicability concerns were excluded (AUC, 0.931; SE, 0.020). In a subgroup analysis, 18 F-FDG PET/CT was found to have a significantly higher specificity (0.89 vs. 0.79) than 18 F-FDG PET alone, with no evidence of significant difference in the overall performance (AUC, 0.930 vs. 0.891; 2-tailed P value for difference, 0.31). Conclusion: This meta-analysis of available studies demonstrates that whole-body 18 F-FDG PET or 18 F-FDG PET/CT has high diagnostic accuracy and moderate to high sensitivity and specificity for detection of underlying malignancy in patients suspected of having a paraneoplastic syndrome.

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Section: Discussionmentioning

confidence: 99%

Whole-Body ¹⁸F-FDG PET and ¹⁸F-FDG PET/CT in Patients with Suspected Paraneoplastic Syndrome: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

et al. 2016

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“…Reimbursement by the Centers for Medicare and Medicaid Services for 18 F-FDG PET was based on complex decision-tree sensitivity analyses for cost effectiveness (5) and on large, national, prospective studies evaluating changes in management (6). Until the anonymous authors provide solid arguments, we will be relentless in opposing such actions.…”

Section: Humana and 18 F-fdg Pet/ct: Another Sequel To The Injustice Of Being Judged By The Errors Of Othersmentioning

confidence: 99%

Humana and ¹⁸F-FDG PET/CT: Another Sequel to the Injustice of Being Judged by the Errors of Others

Czernin¹,

Iagaru

2020

J Nucl Med

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Paraneoplastic Syndromes

Pelosof

Gerber

2018

The American Cancer Society's Oncology in Practice

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Impact on Patient Management of [18F]-Fluorodeoxyglucose-Positron Emission Tomography (PET) Used for Cancer Diagnosis: Analysis of Data From the National Oncologic PET Registry

Cited by 12 publications

References 33 publications

Whole-Body ¹⁸F-FDG PET and ¹⁸F-FDG PET/CT in Patients with Suspected Paraneoplastic Syndrome: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

Whole-Body ¹⁸F-FDG PET and ¹⁸F-FDG PET/CT in Patients with Suspected Paraneoplastic Syndrome: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

Humana and ¹⁸F-FDG PET/CT: Another Sequel to the Injustice of Being Judged by the Errors of Others

Paraneoplastic Syndromes

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Impact on Patient Management of [18F]-Fluorodeoxyglucose-Positron Emission Tomography (PET) Used for Cancer Diagnosis: Analysis of Data From the National Oncologic PET Registry

Cited by 12 publications

References 33 publications

Whole-Body 18F-FDG PET and 18F-FDG PET/CT in Patients with Suspected Paraneoplastic Syndrome: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

Whole-Body 18F-FDG PET and 18F-FDG PET/CT in Patients with Suspected Paraneoplastic Syndrome: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

Humana and 18F-FDG PET/CT: Another Sequel to the Injustice of Being Judged by the Errors of Others

Paraneoplastic Syndromes

Contact Info

Product

Resources

About

Whole-Body ¹⁸F-FDG PET and ¹⁸F-FDG PET/CT in Patients with Suspected Paraneoplastic Syndrome: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

Whole-Body ¹⁸F-FDG PET and ¹⁸F-FDG PET/CT in Patients with Suspected Paraneoplastic Syndrome: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

Humana and ¹⁸F-FDG PET/CT: Another Sequel to the Injustice of Being Judged by the Errors of Others