Diagnostic Performance of 18F-FDG PET(CT) in Bone-Bone Marrow Involvement in Pediatric Neuroblastoma: A Systemic Review and Meta-Analysis

Abstract

Objective. We sought to perform a systemic review and meta-analysis of the diagnostic performance of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (computed tomography) (PET(CT)) in detection of bone and/or bone marrow involvement (BMI) in pediatric neuroblastoma (NB). Materials and Methods. We searched electronic databases Pubmed and Embase to retrieve relevant references. We calculated pooled sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR−), diagnostic odds ratio (DOR), and the area under the curve (AUC). Moreover, a summary receiver operating characteristic (SROC) curve and likelihood ratio dot plot were plotted. Study-between statistical heterogeneity was evaluated via I-square index (I2). Subgroup analyses were used to explore heterogeneity. Results. Seven studies including 127 patients were involved in this meta-analysis. The overall sensitivity and specificity were 0.87 (95% CI: 0.65–0.96) with heterogeneity I2 = 88.1% ( $p<0.001$ ) and 0.96 (95% CI: 0.67–1.00) with heterogeneity I2 = 77.8% ( $p<0.001$ ), respectively. The pooled LR+, LR−, and DOR were 21.3 (95% CI: 2.1–213.9), 0.14 (95% CI: 0.05–0.40), and 157 (95% CI: 16–1532), respectively. The area under the SROC curve was 0.97 (95% CI: 0.95–0.98). Conclusions. Through a meta-analysis, this study suggested that 18F-FDG PET(CT) has a good overall diagnostic accuracy in the detection of bone/BMI in pediatric neuroblastoma.