Predictive Value of 18F-FDG PET/CT for Assessment of Tumor Response to Neoadjuvant Chemotherapy in Bladder Cancer

Abstract

Objective The purpose of the current study was to evaluate the diagnostic accuracies of 18F-FDG PET/CT for prediction of tumor response to neoadjuvant chemotherapy in bladder cancer (BC) patients through a systematic review and meta-analysis. Patients and Methods The PubMed, Cochrane database, and Embase database were searched from inception through November 30, 2022 for studies evaluating diagnostic performance of 18F-FDG PET/CT for prediction of tumor response to neoadjuvant chemotherapy in BC patients. Based on data extracted from patient-based and lesion-based analysis, we calculated the pooled sensitivity and specificity with the 95% confidence intervals (CIs). Also, we calculated positive and negative likelihood ratios (LR+ and LR−), and constructed summary receiver operating characteristic curves. Results Across 5 studies (12 results), the pooled sensitivity of 18F-FDG PET/CT was 0.84 (95% CI, 0.72–0.91), and the pooled specificity was 0.75 (95% CI, 0.59–0.86). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 3.3 (95% CI, 2.0–5.6) and negative likelihood ratio (LR−) of 0.22 (95% CI, 0.12–0.38). The pooled diagnostic odds ratio was 15 (95% CI, 7–36). The pooled sensitivity of 18F-FDG PET/CT for prediction of pathologic complete response was 0.68 (95% CI, 0.56–0.78), and the pooled specificity was 0.77 (95% CI, 0.60–0.88). The pooled sensitivity of 18F-FDG PET/CT for prediction of clinical response and nonresponse was 0.94 (95% CI, 0.85–0.98), and a pooled specificity was 0.73 (95% CI, 0.42–0.91). Conclusions 18F-FDG PET/CT showed a good diagnostic performance for prediction of tumor response to neoadjuvant chemotherapy in BC patients.