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  • Preoperative staging of cholangiocarcinoma and biliary carcinoma using 18F-fluorodeoxyglucose positron emission tomography: a meta-analysis

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Hematology/Oncology
Original research
Preoperative staging of cholangiocarcinoma and biliary carcinoma using 18F-fluorodeoxyglucose positron emission tomography: a meta-analysis
  1. Jing-Hong Hu1,
  2. Jui-hsiang Tang2,
  3. Cheng-Hui Lin3,4,
  4. Yin-Yi Chu3,4,
  5. Nai-Jen Liu3,4
  1. 1 Department of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Yunlin, Taiwan
  2. 2 Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University Hospital, Taipei, Taiwan
  3. 3 Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taiwan
  4. 4 Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
  1. Correspondence to Dr Nai-Jen Liu, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taiwan and Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; launaijn.tw{at}yahoo.com.tw

Abstract

This meta-analysis was performed to determine the diagnostic accuracy of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) in assessing primary cholangiocarcinoma (CCA) and CCA with lymph node and distant metastasis. A literature search for studies reporting the use of 18F-FDG-PET for preoperative work-up/staging in patients with CCA was performed. Diagnostic OR (DOR) was used as an index of diagnostic performance of FDG-PET/CT in predicting primary CCA, lymph node metastases, and distant metastases. The pooled DOR was 9.34 (95% CI 4.27 to 20.42) and the area under the summary receiver operating characteristic (SROC) curve was 0.8643 (SE=0.0362), indicating overall good discriminatory test performance in predicting primary CCA. Subgroup analyses based on the primary tumor site showed better diagnostic performance for intrahepatic CCA (DOR=54.44, 95% CI 13.44 to 220.49), both intrahepatic and extrahepatic CCA (DOR=32.96, 95% CI 1.41 to 768.80) and gallbladder cancer (DOR=12.93, 95% CI 1.97 to 84.80), than for extrahepatic CCA (DOR=2.55, 95% CI 0.71 to 9.20) and hilar CCA (DOR=2.75, 95% CI 0.17 to 43.72). The pooled DOR for the prediction of lymph nodes metastases in 10 studies was 11.34 (95% CI 4.79 to 26.80), with moderate heterogeneity (Cochran Q=15.14, p=0.0872, I2=40.5%). The area under the SROC curve was 0.8584 (SE=0.0729). In conclusion, 18F-FDG-PET and PET/CT were found to be accurate in the evaluation of primary tumors, lymph node metastasis, and distant metastasis in patients with CCA.

  • meta-analysis
  • lymph node metastasis
  • cholangiocarcinoma
  • 18F-FDG-PET

http://dx.doi.org/10.1136/jim-2017-000472

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    Footnotes

    • Contributors J-HH: study concepts, study design, definition of intellectual content, clinical studies, experimental studies, data acquisition, data analysis, statistical analysis and manuscript preparation. J-T: definition of intellectual content, literature research, data acquisition, data analysis and statistical analysis. C-HL: literature research and manuscript editing. Y-YC: study design and clinical studies. N-JL: guarantor of integrity of the entire study, manuscript editing and manuscript review. All authors have read and approved the final version to be submitted.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.