Is fluorine-18 fluorodeoxyglucose positron emission tomography useful for the thyroid nodules with indeterminate fine needle aspiration biopsy? a meta-analysis of the literature

Journal of Otolaryngology-Head & Neck Surgery

Yingli Lu¹  Hualing Zhai¹  Ningjian Wang¹ 

[1] Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, No. 639, Zhizaoju Road, Shanghai 200011, China

关键词: Indeterminate;    Fine needle aspiration biopsy;    Thyroid nodule;    Meta-analysis;    Positron emission tomography;    Fluorine-18 fluorodeoxyglucose;   

Others  :  861643
DOI  :  10.1186/1916-0216-42-38

 received in 2013-02-04, accepted in 2013-05-25,  发布年份 2013

【 摘 要 】

Background

The indeterminate fine needle aspiration biopsy (FNAB) results present a clinical dilemma for physicians. The aim of this study was to evaluate the diagnostic accuracy of fluorine-18 fluorodeoxyglucose positron emission tomography (¹⁸ F-FDG PET) in the detection of these indeterminate lesions.

Methods

Seven studies (involving a total of 267 patients) published before November 2012 were reviewed. Systematic methods were used to identify, select, and evaluate the methodological quality of the studies as well as to summarize the overall findings of sensitivity and specificity.

Results

A total number of 70 patients were confirmed to have malignant lesions, with a cancer prevalence of 26.2% (70/267; ranging from 19.6% to 40.0% in these studies). The pooled sensitivity and specificity of PET or PET/CT for the detection of cancer was 89.0% (95% CI: 79.0% ~ 95.0%) and 55.0% (95% CI: 48.0% ~ 62.0%), respectively. There was no evidence of threshold effects or publication bias. The area [±standard error (±SE)] under the symmetrical sROC curve was 0.7207 ± 0.1041. Although SUVmax was higher in malignant lesions (P < 0.01), there was still a great overlap. The best cut-off value of SUVmax for differentiation was 2.05; but with a high sensitivity of 89.8% and low specificity of 42.0%.

Conclusion

F-FDG PET or PET/CT showed a high sensitivity in detecting thyroid cancers in patients with indeterminate FNAB results. Further examination was strongly recommended when an FDG-avid lesion was detected.

【 授权许可】

   
2013 Wang et al.; licensee BioMed Central Ltd.

【 图 表 】

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