Accuracy Of Diagnosing Pelvic Lymph Node Metastasis In Cervical Cancer With PET/CT: A Meta Analysis

Objective:To review studies focused on diagnosing pelvic lymph node metastasis in cervical cancer with PET/CT, analysed sources of bias and variability and evaluated the diagnostic accuracy with meta analysis. Methods:Searched current literature in database without limiting time and language, evaluated the quality of included studies according to QUADAS (quality assessment of diagnostic accuracy studies), Meta Disc version 1.40 software was used to analysed source of heterogeneity with Q-test, pool sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR) and AUC, than drew SROC curves. Results:Nine studies met the inclusion criteria, eight literatures write in English and one in Chinese. cervical cancer of 346 cases (3979 lymph node metastasis).were included, we pooled data with random effects model on lymph nodes level:sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, accuracy and AUC value were 0.58 (95% CI: 0.51-0.65),0.98 (95% CI:0.98-0.99),0.686 (0.464-0.852),0.936(0.833-0.995),2.15(7.20-64.24), 0.43(0.32-0.58),0.900 (0.75-0.993),0.7724, respectively; pooled analysis with random effects model based on patient level:sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, accuracy and AUC value were 0.54 (95% CI:0.45-0.63),0.86 (95% CI:0.98-0.99),0.725(0.471-0.923),0.765(0.615-0.886),4.58(1.86-11.31), 0.52 (0.34-0.80),0.756(0.620-0.0.897) and 0.8699, respectively. Conclusion:PET/CT has moderate diagnostic value for evaluating pelvic lymph node metastasis in cervical cancer, which can provide reliable guidance in clinical practice.