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Diagnostic Performance of Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography Imaging in Uterine Sarcomas: Systematic Review and Meta-Analysis of the Literature
  1. Ramin Sadeghi, MD*,
  2. Seyed Rasoul Zakavi, MD*,
  3. Malihe Hasanzadeh, MD,,
  4. Giorgio Treglia, MD§,
  5. Luca Giovanella, MD§ and
  6. Sima Kadkhodayan, MD,
  1. *Nuclear Medicine Research Center,
  2. Women’s Health Research Center, Mashhad University of Medical Sciences;
  3. Faculty of Medicine, Ghaem Hospital, Mashhad, Iran; and
  4. §Department of Nuclear Medicine and PET/CT Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
  1. Address correspondence and reprint requests to Giorgio Treglia, MD, Department of Nuclear Medicine and PET Center, Oncology Institute of Southern Switzerland, via Ospedale, 12, 6500 Bellinzona, Switzerland. E-mail: giorgiomednuc@libero.it.

Abstract

Objective We reviewed the medical literature on the application of fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET) imaging in the management of uterine sarcomas and presented the results in systematic review and meta-analysis format.

Methods Medline, SCOPUS, and ISI Web of Knowledge were searched electronically with “PET AND (Uterine OR Uterus)” as key words. All studies evaluating the accuracy of 18F-FDG imaging in the staging or restaging of uterine sarcomas were included if enough data could be extracted for calculation of sensitivity and/or specificity.

Results Eight studies were included in the systematic review. Only 2 studies reported the accuracy of 18F-FDG PET imaging in the primary staging of uterine sarcoma with low sensitivity for lymph node staging. For restaging (detection of recurrence), all 8 included studies had quantitative data, and the patient-based pooled sensitivity and specificity were 92.1% (95% confidence interval [95% CI], 82.4–97.4) and 96.2% (95% CI, 87–99.5), respectively. On a lesion-based analysis, sensitivity was 86.3% (95% CI, 76.7–92.9), and specificity was 94.4% (95% CI, 72.7–99.9). Device used (PET vs PET/CT), spectrum of studied patients, and histology of the sarcoma seem to be factors influencing the overall accuracy of 18F-FDG PET imaging.

Conclusions 8Fluorine-18-fluorodeoxyglucose PET and PET/CT seem to be accurate methods for detection and localization of recurrence in patients with uterine sarcoma. Further large multicenter studies are needed to validate our results and to correlate both sarcoma type and spectrum of patients to the diagnostic performance of 18F-FDG PET imaging in recurrence detection. The studies evaluating the accuracy of 18F-FDG PET imaging for the primary staging of uterine sarcoma are very limited, and no definite conclusion can be made in this regard.

  • Uterine sarcoma
  • Uterus
  • Positron emission tomography
  • PET
  • Meta-analysis

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Footnotes

  • This study is a result of a thesis that has been conducted as a joint project in Nuclear Medicine Research Center and Women’s Health Research Center of Mashhad University of Medical Sciences. Vice chancellery of Research of Mashhad University of Medical Sciences financially supported this thesis (with approval no. 900786).

  • The authors declare no conflicts of interest.

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