Diagnostic value of [18F]FDG PET/MRI in the detection of lymph node metastasis of cervical cancer: a meta-analysis

Purpose The aim of this meta-analysis was to assess the diagnostic potential and application value of F-18 fludeoxyglucose ( [F-18]FDG) positron emission tomography/ magnetic resonance imaging (PET/MRI) for lymph node metastasis detection in cervical cancer. Methods We searched in PubMed, Web of Science, and Embase database for relevant articles with search dates from 1998 to December 2023. All articles on ( [F-18]FDG PET/MRI for diagnosis of lymph node metastasis in cervical cancer were extracted and further evaluated. The combined sensitivity, specificity, PLR, NLR, and ROC curve of ( [F-18]FDG PET/MRI were calculated to assess its diagnostic capability. Results 7 studies that satisfied the criteria were eventually included, including 481 patients. The combined sensitivity of ( [F-18]FDG PET/MRI for detecting lymph node metastasis of cervical cancer was 0.85 (0.67-0.94), and the combined specificity was 0.94 (0.90-0.97). The AUC (Area Under Curve) value was 0.96 (0.93-0.97). The PLR (Positive Likelihood Ratio), and NLR (Negative Likelihood Ratio) were 14.32 (8.44-24.31) and 0.16 (0.06-0.38), respectively. When the pre-test likelihood was set at 50%, the post-test likelihood rose to 93%. Conclusions ( [F-18]FDG PET/MRI showed promising clinical utility and diagnostic value in evaluating lymph node staging in cervical cancer, and demonstrated relatively high sensitivity and specificity. However, to draw stronger evidence-based conclusions, large-scale clinical trials should be conducted to provide stronger and more reliable support for its clinical application.