Diagnostic accuracy of fluorine-18-fluorodeoxyglucose positron emission tomography in gallbladder cancer: A meta-analysis

AIM: To meta-analyze published data about the diagnostic accuracy of fluorine-18-fluorodeoxyglucose(18F-FDG) positron emission tomography(PET) and PET/computed tomography(PET/CT) in the evaluation of primary tumor in patients with gallbladder cancer(GBCa).METHODS: A comprehensive literature search of studies published through 30 th June 2014 regarding the role of 18F-FDG PET and PET/CT in the evaluation of primary gallbladder cancer(GBCa) was performed. All retrieved studies were reviewed. Pooled sensitivity and specificity of 18F-FDG PET or PET/CT in the evaluation of primary GBCa were calculated. The area under the summary receiving operator characteristics curve(AUC) was calculated to measure the accuracy of these methods. Sub-analyses considering the device used(PET vs PET/CT) were carried out.RESULTS: Twenty-one studies comprising 495 patients who underwent 18F-FDG PET or PET/CT for suspicious GBCa were selected for the systematic review. The meta-analysis of 13 selected studies provided the following results: sensitivity 87%(95%CI: 82%-92%),specificity 78%(95%CI: 68%-86%). The AUC was 0.88. Improvement of sensitivity and specificity was observed when PET/CT was used.CONCLUSION: 18F-FDG-PET and PET/CT demonstrated to be useful diagnostic imaging methods in the assessment of primary tumor in GBCa patients,nevertheless possible sources of false-negative and false-positive results should be kept in mind. PET/CT seems to have a better diagnostic accuracy than PET alone in this setting.