Diagnostic test accuracies of F-18 FDG PET/CT for prediction of microvascular invasion of hepatocellular carcinoma: A meta-analysis

Purpose: The aim of the current meta-analysis was to evaluate diagnostic accuracies of preoperative F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) for prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients. Methods: The scientific database such as PubMed, Cochrane, and Embase database were searched for studies evaluating diagnostic accuracies of preoperative F-18 FDG PET or PET/CT for prediction of MVI in HCC patients up to November 30, 2020. Results: Fourteen eligible studies (1276 patients) were enrolled. The pooled sensitivity for F-18 FDG PET or PET/ CT was 0.67 (95% CI; 0.57-0.76) with heterogeneity and a pooled specificity of 0.80 (95% CI; 0.74-0.85) with heterogeneity. Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 3.3 (95% CI; 2.5-4.5) and negative likelihood ratio (LR-) of 0.41 (95% CI; 0.31-0.55). The pooled diagnostic odds ratio (DOR) was 8 (95% CI; 5-14). Summary receiver operating characteristic (ROC) curve indicates that the area under the curve was 0.81 (95% CI; 0.78-0.84). Conclusion: The current meta-analysis showed a low sensitivity and moderate specificity of F-18 FDG PET or PET/ CT for the prediction of MVI in HCC patients. F-18 FDG PET or PET/CT might not be useful for the preoperative prediction of MVI in HCC patients and should not be used to exclude MVI. Therefore, cautious application and interpretation should be paid to the F-18 FDG PET or PET/CT for the prediction of MVI in HCC patients preoperatively.

Automated summary

This meta-analysis evaluated the diagnostic accuracies of preoperative F-18 FDG PET or PET/CT for prediction of MVI in HCC patients, showing low sensitivity and moderate specificity. It suggests cautious application and interpretation of F-18 FDG PET or PET/CT for preoperative prediction of MVI in HCC patients.