A Two-way Comparison of Whole-body 18F-FDG PET/CT and PET/MRI for Distant Metastasis in Patients with Malignant Tumors: A Meta-analysis

Abstract

Abstract Background As an evolving imaging modality, whole-body fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) and 18F-FDG PET/magnetic resonance imaging (MRI) had been preliminarily applied in clinical practice. However, PET/MRI may be superior to 18F-FDG PET/CT for the diagnosis of distant metastasis. Therefore, it is timely and important to systematically determine the diagnostic accuracy of 18F-FDG-PET/MRI compared with that of 18F-FDG PET/CT for the diagnosis of distant metastasis. Methods The aim of this study was to compare the diagnostic accuracy of PET/CT and PET/MRI for the diagnosis of distant metastasis in patients with malignant tumors. Relevant studies using 18F-FDG PET/CT and PET/MRI for assessment of distant metastasis in the same patients with malignant tumors were systematically identified using PubMed, Embase, and the Cochrane Library until March 2021. Two reviewers independently selected studies according to the inclusion and exclusion criteria. A reviewer extracted relevant data and assessed the quality of the eligible studies. The pooled sensitivity (Se), specificity (Sp), positive likelihood ratio, negative likelihood ratio, and area under the summary receiver operating characteristic curve (SROC) for 18F-FDG PET/CT and PET/MRI were analyzed. Subgroup analysis was performed. Results Across 14 studies (919 patients), 18F-FDG PET/MRI had a higher Se (0.87 versus 0.83), Sp (0.96 versus 0.95), and SROC value (0.97 versus 0.974) than PET/CT for detecting distant metastasis. In the 3 studies of distant metastasis of breast cancer (182 patients), 18F-FDG PET/MRI had a higher Se (0.95 versus 0.87) and Sp (0.96 versus 0.94) than PET/CT. In the 4 studies of lung cancer (311 patients), 18F-FDG PET/MRI had a similar Se (0.92 versus 0.92) and Sp (0.95 versus 0.95) to PET/CT. Conclusions In general, PET/MRI had higher diagnostic accuracy than 18F-FDG PET/CT for assessing distant metastasis in patients with various tumors and breast cancer. 18F-FDG PET/MRI and PET/CT both performed well in the diagnosis of distant metastasis in patients with lung cancer.