18 FDG-PET/CT for the detection of regional nodal metastasis in patients with primary head and neck cancer before treatment: A

Background: We performed a meta-analysis to evaluate the role of 18 F-fluorodeoxyglucose positron emissiontomography/computedtomography( 18 FDG-PET/CT)inthe detectionofregionalnodalmetastasis in patients with primary head and neck cancer before treatment. Materials and methods: Studiesabout 18 FDG-PET/CTforthedetectionofregionalnodalmetastasisinpatients with primary HNC were systematicallysearched in the MEDLINE,EMBASE, and EBM Review databases from January 1, 2000 to July 25, 2012. A software called “Stata 12.0” was used to obtain pooled estimates of sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for PET/CT. We also calculated hierarchic summary receiver operating characteristic (HSROC) curves and area under the curves. Results: 14articles(742patients)fulfilledallinclusioncriteria.Thepooledsensitivity,andspecificitywith95% confidence interval for PET/CT on a per-neck-side analysis were 0.84 (0.77e0.89) and 0.84 (0.78e0.89). The corresponding values for PET/CTon a per-nodal-level analysis 0.84 (0.78e0.88) and 0.96 (0.94e0.98). Conclusions: 18 FDG-PET/CT had good diagnostic performance for the detection of regional nodal metastasis in patients with primary head and neck cancer before treatment.