Fluorine-18-fluorodeoxyglucose positron emission tomography to evaluate recurrent gastric cancer after surgical resection: a systematic review and meta-analysis

We aimed to explore the diagnostic accuracy of F-18-fluorodeoxyglucose positron emission tomography (F-18-FDG PET) for detection of gastric cancer recurrence after surgical resection through a systematic review and meta-analysis. PubMed, EMBASE, Web of Knowledge and Springer, from the beginning of 2002 to Feb 2015, were searched for studies evaluating the diagnostic performance of 18F-FDG PET in detecting recurrent gastric cancer. We calculated sensitivities, specificities, diagnostic odds ratios and likelihood ratios, and constructed summary receiver operating characteristic curves. Fourteen studies (828 patients) were included. On a per-patient basis, the forest plots showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of F-18-FDG PET or PET/CT were 0.85 [95 % confidence interval (CI) 0.75-0.92], 0.78 (95 % CI 0.72-0.84), 3.9 (95 % CI 2.9-5.4), 0.19 (95 % CI 0.11-0.34), and 21 (95 % CI 9-47), respectively. On a per-lesion basis, the pooled sensitivity was 0.75 (95 % CI 0.61-0.86). The area under the SROC curve of PET/CT on the basis of per-patient was 0.86. F-18-FDG PET had great value in the detection of gastric cancer recurrence after surgical resection. The sensitivities of F-18-FDG PET were 85 and 75 %, respectively, on per-patient basis and on per-lesion basis.