TY - JOUR
T1 - Colorectal liver metastases: CT, MR imaging, and PET for diagnosis - Meta-analysis
AU - Bipat, Shandra
AU - van Leeuwen, Maarten S.
AU - Comans, Emile F. I.
AU - Pijl, Milan E. J.
AU - Bossuyt, Patrick M. M.
AU - Zwinderman, Aeilko H.
AU - Stoker, Jaap
PY - 2005
Y1 - 2005
N2 - PURPOSE: To perform a meta-analysis to obtain sensitivity estimates of computed tomography (CT), magnetic resonance (MR) imaging and fluorine 18 fluorodeoxy- , glucose (FDG) positron emission tomography (PET) for detection of colorectal liver metastases on per-patient and per-lesion bases. MATERIALS AND METHODS: MEDLINE, EMBASE, Web of Science and CANCERLIT, databases and Cochrane Database of Systematic Reviews were searched for including original articles published from January 1990 to December 2003. Criteria for inclusion of articles were as follows: Articles were reported in the English German or,, French language; CT, MR imaging, or FDG PET was performed to identify and characterize colorectal liver metastases; histopathologic analysis (surgery, biopsy, or autopsy), intraoperative observation (manual palpatation, intraoperative ultrasonography [US]), and/or follow-up US was the reference standard; and data were sufficient for calculation of true-positive or false-negative values. A random-effects linear regression model was used to obtain sensitivity estimates in assessment of liver metastases. RESULTS: Of 165 identified relevant articles, 61 fulfilled all inclusion criteria Sen. sitivity estimates on a per-patient basis for nonhelical CT, helical CT, 1.5-T MR imaging, and FDG PET were 60.2%, 64.7%, 75.8%, and 94.6%, respectively; FDG PET was the most accurate modality. On a per-lesion basis, sensitivity estimates for nonhelical CT, helical CT, 1.0-T MR imaging, 1.5-T MR imaging, and FDG PET were 52.3%, 63.8%, 66.1%, 64.4%, and 75.9%, respectively; nonhelical CT had lowest sensitivity. Estimates of gadolinium-enhanced MR imaging and superparamagnetic iron oxide (SPIO)-enhanced MR imaging were significantly better, compared with nonenhanced MR imaging (P =.019 and P <.001, respectively) and with helical CT with 45 g of iodine or less (P =.02 and P <.001, respectively). For lesions of I cm or larger, SPIO-enhanced MR imaging was the most accurate modality (P <.001). CONCLUSION: FDG PET had significantly higher sensitivity on a per-patient basis, compared with that of the other modalities, but not on a per-lesion basis. Sensitivity estimates for MR imaging with contrast agent were significantly superior to those for helical CT with 45 g of iodine or less. (c) RSNA, 2005
AB - PURPOSE: To perform a meta-analysis to obtain sensitivity estimates of computed tomography (CT), magnetic resonance (MR) imaging and fluorine 18 fluorodeoxy- , glucose (FDG) positron emission tomography (PET) for detection of colorectal liver metastases on per-patient and per-lesion bases. MATERIALS AND METHODS: MEDLINE, EMBASE, Web of Science and CANCERLIT, databases and Cochrane Database of Systematic Reviews were searched for including original articles published from January 1990 to December 2003. Criteria for inclusion of articles were as follows: Articles were reported in the English German or,, French language; CT, MR imaging, or FDG PET was performed to identify and characterize colorectal liver metastases; histopathologic analysis (surgery, biopsy, or autopsy), intraoperative observation (manual palpatation, intraoperative ultrasonography [US]), and/or follow-up US was the reference standard; and data were sufficient for calculation of true-positive or false-negative values. A random-effects linear regression model was used to obtain sensitivity estimates in assessment of liver metastases. RESULTS: Of 165 identified relevant articles, 61 fulfilled all inclusion criteria Sen. sitivity estimates on a per-patient basis for nonhelical CT, helical CT, 1.5-T MR imaging, and FDG PET were 60.2%, 64.7%, 75.8%, and 94.6%, respectively; FDG PET was the most accurate modality. On a per-lesion basis, sensitivity estimates for nonhelical CT, helical CT, 1.0-T MR imaging, 1.5-T MR imaging, and FDG PET were 52.3%, 63.8%, 66.1%, 64.4%, and 75.9%, respectively; nonhelical CT had lowest sensitivity. Estimates of gadolinium-enhanced MR imaging and superparamagnetic iron oxide (SPIO)-enhanced MR imaging were significantly better, compared with nonenhanced MR imaging (P =.019 and P <.001, respectively) and with helical CT with 45 g of iodine or less (P =.02 and P <.001, respectively). For lesions of I cm or larger, SPIO-enhanced MR imaging was the most accurate modality (P <.001). CONCLUSION: FDG PET had significantly higher sensitivity on a per-patient basis, compared with that of the other modalities, but not on a per-lesion basis. Sensitivity estimates for MR imaging with contrast agent were significantly superior to those for helical CT with 45 g of iodine or less. (c) RSNA, 2005
U2 - https://doi.org/10.1148/radiol.2371042060
DO - https://doi.org/10.1148/radiol.2371042060
M3 - Article
C2 - 16100087
SN - 0033-8419
VL - 237
SP - 123
EP - 131
JO - Radiology
JF - Radiology
IS - 1
ER -