Published online Aug 7, 2013. doi: 10.3748/wjg.v19.i29.4808
Revised: May 2, 2013
Accepted: May 16, 2013
Published online: August 7, 2013
AIM: To investigate the potential role of positron emission tomography (PET) in the diagnosis, staging and prognosis predicting of pancreatic carcinoma (PC).
METHODS: A systematic review of relevant literatures in PubMed, Embase and Cochrane Library was performed. The sensitivity and specificity of diagnostic and staging studies, and HRs for prognosis predicting studies were pooled. The bivariate model was used for diagnostic studies and the random-effect model for prognostic studies. Heterogeneity between included studies was tested using χ2 test, and subgroup analysis was performed to explain the heterogeneities. All of the calculations were performed using Stata version 11.0.
RESULTS: A total of 39 studies were included. The pooled sensitivity of PET in diagnosing PC (30 studies, 1582 patients), evaluating N stating (4 studies, 101 patients) and liver metastasis (7 studies, 316 patients) were 0.91 (95%CI: 0.88-0.93), 0.64 (95%CI: 0.50-0.76), and 0.67 (95%CI: 0.52-0.79), respectively; and the corresponding specificity was 0.81 (95%CI: 0.75-0.85), 0.81 (95%CI: 0.25-0.85), and 0.96 (95%CI: 0.89-0.98), respectively. In prognosis analysis (6 studies, 198 patients), significant difference of overall survival was observed between high and low standardized uptake value groups (HR = 2.39, 95%CI: 1.57-3.63). Subgroup analysis showed that PET/CT was more sensitive than PET alone in evaluating liver metastasis of PC, 0.82 (95%CI: 0.48-0.98) and 0.67 (95%CI: 0.52-0.79), respectively.
CONCLUSION: PET can be used as a valuable diagnostic and predictive tool for PC, but its effect in the staging of PC remains indeterminate.
Core tip: Positron emission tomography (PET) is an important tool for the diagnosis, staging and prognosis predicting of tumors. However, no consensus has been reached with regard to the role of PET in pancreatic carcinoma (PC) diagnosis. We performed meta-analysis of 39 included studies. The pooled results showed that PET can be used as a valuable diagnostic and predictive tool for PC, but its effect in the staging remains indeterminate. New tracers and PET scanning technology, as well as other parameters besides of standardized uptake value should be noticed in order to improve the diagnostic and predictive accuracy of PET in PC.