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Open AccessSystematic Review
Predicting Complete Cytoreduction with Preoperative [18F]FDG PET/CT in Patients with Ovarian Cancer: A Systematic Review and Meta-Analysis
by
Csaba Csikos
Csaba Csikos 1,2,†,
Péter Czina
Péter Czina 1,†,
Szabolcs Molnár
Szabolcs Molnár 3,
Anna Rebeka Kovács
Anna Rebeka Kovács 1,
Ildikó Garai
Ildikó Garai 1,2,4,‡ and
Zoárd Tibor Krasznai
Zoárd Tibor Krasznai 3,*,‡
1
Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
2
Gyula Petrányi Doctoral School of Clinical Immunology and Allergology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
3
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
4
Scanomed Ltd., H-4032 Debrecen, Hungary
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
‡
These authors also contributed equally to this work.
Diagnostics 2024, 14(16), 1740; https://doi.org/10.3390/diagnostics14161740 (registering DOI)
Submission received: 22 July 2024
/
Revised: 8 August 2024
/
Accepted: 9 August 2024
/
Published: 10 August 2024
Abstract
The cornerstone of ovarian cancer treatment is complete surgical cytoreduction. The gold-standard option in the absence of extra-abdominal metastases and intra-abdominal inoperable circumstances is primary cytoreductive surgery (CRS). However, achieving complete cytoreduction is challenging, and only possible in a selected patient population. Preoperative imaging modalities such as [18F]FDG PET/CT could be useful in patient selection for cytoreductive surgery. In our systematic review and meta-analysis, we aimed to evaluate the role of preoperative [18F]FDG PET/CT in predicting complete cytoreduction in primary and secondary debulking surgeries. Publications were pooled from two databases (PubMed, Mendeley) with predefined keywords “(ovarian cancer) AND (FDG OR PET) AND (cytoreductive surgery)”. The quality of the included studies was assessed with the Prediction model Risk Of Bias Assessment Tool (PROBAST). During statistical analysis, MetaDiSc 1.4 software and the DerSimonian–Laird method (random effects models) were used. Primary and secondary cytoreductive surgeries were evaluated. Pooled sensitivities, specificities, positive predictive values (PPVs), and negative predictive values (NPVs) were calculated and statistically analyzed. Results were presented in forest plot diagrams and summary receiver operating characteristic (SROC) curves. Overall, eight publications were included in our meta-analysis. Four publications presented results of primary, three presented results of secondary cytoreductions, and two presented data related to both primary and secondary surgery. Pooled sensitivities, specificities, and positive and negative predictive values were the following: in the case of primary surgeries: 0.65 (95% CI 0.60–0.71), 0.73 (95% CI 0.66–0.80), 0.82 (95% CI 0.77–0.87), 0.52 (95% CI 0.46–0.59); and in the case of secondary surgeries: 0.91 (95% CI 0.84–0.95), 0.48 (95% CI 0.30–0.67), 0.88 (95% CI 0.81–0.93), 0.56 (95% CI 0.35–0.75), respectively. The PPVs of [18F]FDG PET/CT proved to be higher in cases of secondary debulking surgeries; therefore, it can be a valuable predictor of complete successful secondary cytoreduction.
Share and Cite
MDPI and ACS Style
Csikos, C.; Czina, P.; Molnár, S.; Kovács, A.R.; Garai, I.; Krasznai, Z.T.
Predicting Complete Cytoreduction with Preoperative [18F]FDG PET/CT in Patients with Ovarian Cancer: A Systematic Review and Meta-Analysis. Diagnostics 2024, 14, 1740.
https://doi.org/10.3390/diagnostics14161740
AMA Style
Csikos C, Czina P, Molnár S, Kovács AR, Garai I, Krasznai ZT.
Predicting Complete Cytoreduction with Preoperative [18F]FDG PET/CT in Patients with Ovarian Cancer: A Systematic Review and Meta-Analysis. Diagnostics. 2024; 14(16):1740.
https://doi.org/10.3390/diagnostics14161740
Chicago/Turabian Style
Csikos, Csaba, Péter Czina, Szabolcs Molnár, Anna Rebeka Kovács, Ildikó Garai, and Zoárd Tibor Krasznai.
2024. "Predicting Complete Cytoreduction with Preoperative [18F]FDG PET/CT in Patients with Ovarian Cancer: A Systematic Review and Meta-Analysis" Diagnostics 14, no. 16: 1740.
https://doi.org/10.3390/diagnostics14161740
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