Dataset Information

Optimal Modality for Detecting Distant Metastasis in Primary Nasopharyngeal Carcinoma during Initial Staging: A Systemic Review and Meta-analysis of 1774 Patients.

ABSTRACT: Purpose: To compare the diagnostic performance of two modalities commonly used for detecting distant metastasis in primary nasopharyngeal carcinoma (NPC): ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) and conventional work-ups (CWUs). Methods: All topic-related studies were comprehensively searched and included. We determined sensitivities and specificities across studies, calculated negative and positive likelihood ratios (LR- and LR+, respectively), and constructed summary receiver operating characteristic curves. Moreover, we compared the diagnostic performance of PET/CT and CWUs by analyzing studies that reported the results of these diagnostic methods on the same patients. Results: The pooled sensitivity and specificity were 85.7% and 98.1% for PET/CT (1474 patients), and 38.0% and 97.6% for CWUs (1329 patients). In the head-to-head comparison of PET/CT and CWUs (1029 patients), PET/CT showed a significantly higher sensitivity (83.7% vs. 40.1%, P < 0.001) and lower LR- (0.169 vs. 0.633, P < 0.001) than CWUs on a per-patient basis; no significant difference was observed in pooled specificity (97.7% vs. 97.8%, P = 0.892) or LR+ (36.416 vs. 16.845, P = 0.149). The superiority of PET/CT over CWUs was due mainly to the better diagnostic performance on bone metastasis. However, suboptimal sensitivity of PET/CT was reported in the aspect of detection of liver metastasis. Sensitivity analyses showed relatively poor sensitivity and LR- of PET/CT compared to the original analysis. Conclusions: PET/CT was superior to CWUs in detecting distant metastasis in primary NPC. However, the efficacy of PET/CT in detecting liver metastasis still requires further optimization.

SUBMITTER: Xu C

PROVIDER: S-EPMC5463439 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Optimal Modality for Detecting Distant Metastasis in Primary Nasopharyngeal Carcinoma during Initial Staging: A Systemic Review and Meta-analysis of 1774 Patients.

Xu Cheng C Zhang Yuan Y Peng Liang L Liu Xu X Li Wen-Fei WF Sun Ying Y Zhang Xu X Lin Xiao-Ping XP Liu Qing Q Ma Jun J

Journal of Cancer 20170410 7

Purpose: To compare the diagnostic performance of two modalities commonly used for detecting distant metastasis in primary nasopharyngeal carcinoma (NPC): 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) and conventional work-ups (CWUs). Methods: All topic-related studies were comprehensively searched and included. We determined sensitivities and specificities across studies, calculated negative and posit ...[more]

PMID: 28607599

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Project description:BackgroundWe aimed to identify a magnetic resonance imaging (MRI)-based model for assessment of the risk of individual distant metastasis (DM) before initial treatment of nasopharyngeal carcinoma (NPC).MethodsThis retrospective cohort analysis included 176 patients with NPC. Using the PyRadiomics platform, we extracted the imaging features of primary tumors in all patients who did not exhibit DM before treatment. Subsequently, we used minimum redundancy-maximum relevance and least absolute shrinkage and selection operator algorithms to select the strongest features and build a logistic model for DM prediction. The independent statistical significance of multiple clinical variables was tested using multivariate logistic regression analysis.FindingsIn total, 2780 radiomic features were extracted. A DM MRI-based model (DMMM) comprising seven features was constructed for the classification of patients into high- and low-risk groups in a training cohort and validated in an independent cohort. Overall survival was significantly shorter in the high-risk group than in the low-risk group (P < 0·001). A radiomics nomogram based on radiomic features and clinical variables was developed for DM risk assessment in each patient, and it showed a significant predictive ability in the training [area under the curve (AUC), 0·827; 95% confidence interval (CI), 0.754-0.900] and validation (AUC, 0.792; 95% CI, 0.633-0.952) cohorts.InterpretationDMMM can serve as a visual prognostic tool for DM prediction in NPC, and it can improve treatment decisions by aiding in the differentiation of patients with high and low risks of DM. FUND: This research received financial support from the National Natural Science Foundation of China (81571664, 81871323, 81801665, 81771924, 81501616, 81671851, and 81527805); the National Natural Science Foundation of Guangdong Province (2018B030311024); the Science and Technology Planning Project of Guangdong Province (2016A020216020); the Scientific Research General Project of Guangzhou Science Technology and Innovation Commission (201707010328); the China Postdoctoral Science Foundation (2016M600145); and the National Key R&D Program of China (2017YFA0205200, 2017YFC1308700, and 2017YFC1309100).

Dataset Information

Optimal Modality for Detecting Distant Metastasis in Primary Nasopharyngeal Carcinoma during Initial Staging: A Systemic Review and Meta-analysis of 1774 Patients.

Publications

Optimal Modality for Detecting Distant Metastasis in Primary Nasopharyngeal Carcinoma during Initial Staging: A Systemic Review and Meta-analysis of 1774 Patients.

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