Attenuation-corrected vs. nonattenuation-corrected 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography in oncology, a systematic review

Purpose: To perform a systematic review and meta-analysis to determine the diagnostic accuracy of attenuation-corrected (AC) vs. nonattenuation-corrected (NAC) 2-deoxy-2-[F-18] fluoro-D-glucose-positron emission tomography (FDG-PET) in oncological patients. Procedures: Following a comprehensive search of the literature, two reviewers independently assessed the methodological quality of eligible studies. The diagnostic value of AC was studied through its sensitivity/ specificity compared to histology, and by comparing the relative lesion detection rate reported with NAC-PET vs. AC, for full-ring and dual-head coincidence PET ( FR- and DH-PET, respectively). Results: Twelve studies were included. For FR- PET, the pooled sensitivity/ specificity on a patient basis was 64/97% for AC and 62/99% for NAC, respectively. Pooled lesion detection with NAC vs. AC was 98% [95% confidence interval ( 95% CI): 96-99%, n=1,012 lesions] for FR-PET, and 88% ( 95% CI: 81-94%, n=288 lesions) for DH-PET. Conclusions: Findings suggest similar sensitivity/ specificity and lesion detection for NAC vs. AC FR- PET and significantly higher lesion detection for NAC vs. AC DH-PET.