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Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer: a systematic review and meta-analysis.
Nucl Med Commun. 2018 Jul; 39(7):645-651.NM

Abstract

OBJECTIVE

To assess the additional value of cervical ultrasonography as supplement to a negative fluorine-18-fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) for detecting cervical lymph node metastases during the initial staging of patients with esophageal cancer.

METHODS

PubMed/Medline, Embase, and the Cochrane library were systematically searched. The analysis included diagnostic studies describing the accuracy of cervical ultrasonography and integrated F-FDG PET/CT or standalone F-FDG PET and CT for detecting cervical lymph node metastases in patients with esophageal cancer. The reference standard consisted of cytopathology and/or clinical follow-up. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the quality of the included studies. A random effects model was used to meta-analyze the additional diagnostic value of cervical ultrasonography.

RESULTS

Four diagnostic studies were eligible and included for meta-analysis, comprising 567 patients with esophageal cancer who underwent diagnostic workup before treatment. The quality of the included studies was considered reasonable; there were few concerns regarding risk of bias and applicability. In three of the four studies, cervical ultrasonography did not detect cervical lymph node metastases in addition to a negative finding on F-FDG PET/CT or standalone F-FDG PET and CT. In one study, cervical ultrasonography detected additional cervical lymph node metastases in 4% (3/74) of patients over standalone F-FDG PET and CT. Pooled estimate of the additional value of cervical ultrasonography was 1% (95% confidence interval: 0-5%).

CONCLUSION

Cervical ultrasonography has very limited additional diagnostic value as supplement to a negative F-FDG PET/CT in the detection of cervical lymph node metastases during the initial staging of patients with esophageal cancer.

Authors+Show Affiliations

Departments of Surgery. Radiation Oncology.Departments of Surgery.Radiation Oncology.Radiology.Radiation Oncology.Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.Departments of Surgery.Departments of Surgery.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

29672463

Citation

Goense, Lucas, et al. "Limited Additional Value of Cervical Ultrasonography Over a Negative 18F-FDG PET/CT for Diagnosing Cervical Lymph Node Metastases in Patients With Esophageal Cancer: a Systematic Review and Meta-analysis." Nuclear Medicine Communications, vol. 39, no. 7, 2018, pp. 645-651.
Goense L, Meziani J, van Rossum PSN, et al. Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer: a systematic review and meta-analysis. Nucl Med Commun. 2018;39(7):645-651.
Goense, L., Meziani, J., van Rossum, P. S. N., Wessels, F. J., Meijer, G. J., Lam, M. G. E. H., van Hillegersberg, R., & Ruurda, J. P. (2018). Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer: a systematic review and meta-analysis. Nuclear Medicine Communications, 39(7), 645-651. https://doi.org/10.1097/MNM.0000000000000847
Goense L, et al. Limited Additional Value of Cervical Ultrasonography Over a Negative 18F-FDG PET/CT for Diagnosing Cervical Lymph Node Metastases in Patients With Esophageal Cancer: a Systematic Review and Meta-analysis. Nucl Med Commun. 2018;39(7):645-651. PubMed PMID: 29672463.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer: a systematic review and meta-analysis. AU - Goense,Lucas, AU - Meziani,Jihane, AU - van Rossum,Peter S N, AU - Wessels,Frank J, AU - Meijer,Gert J, AU - Lam,Marnix G E H, AU - van Hillegersberg,Richard, AU - Ruurda,Jelle P, PY - 2018/4/20/pubmed PY - 2018/9/27/medline PY - 2018/4/20/entrez SP - 645 EP - 651 JF - Nuclear medicine communications JO - Nucl Med Commun VL - 39 IS - 7 N2 - OBJECTIVE: To assess the additional value of cervical ultrasonography as supplement to a negative fluorine-18-fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) for detecting cervical lymph node metastases during the initial staging of patients with esophageal cancer. METHODS: PubMed/Medline, Embase, and the Cochrane library were systematically searched. The analysis included diagnostic studies describing the accuracy of cervical ultrasonography and integrated F-FDG PET/CT or standalone F-FDG PET and CT for detecting cervical lymph node metastases in patients with esophageal cancer. The reference standard consisted of cytopathology and/or clinical follow-up. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the quality of the included studies. A random effects model was used to meta-analyze the additional diagnostic value of cervical ultrasonography. RESULTS: Four diagnostic studies were eligible and included for meta-analysis, comprising 567 patients with esophageal cancer who underwent diagnostic workup before treatment. The quality of the included studies was considered reasonable; there were few concerns regarding risk of bias and applicability. In three of the four studies, cervical ultrasonography did not detect cervical lymph node metastases in addition to a negative finding on F-FDG PET/CT or standalone F-FDG PET and CT. In one study, cervical ultrasonography detected additional cervical lymph node metastases in 4% (3/74) of patients over standalone F-FDG PET and CT. Pooled estimate of the additional value of cervical ultrasonography was 1% (95% confidence interval: 0-5%). CONCLUSION: Cervical ultrasonography has very limited additional diagnostic value as supplement to a negative F-FDG PET/CT in the detection of cervical lymph node metastases during the initial staging of patients with esophageal cancer. SN - 1473-5628 UR - https://www.unboundmedicine.com/medline/citation/29672463/Limited_additional_value_of_cervical_ultrasonography_over_a_negative_18F_FDG_PET/CT_for_diagnosing_cervical_lymph_node_metastases_in_patients_with_esophageal_cancer:_a_systematic_review_and_meta_analysis_ L2 - http://dx.doi.org/10.1097/MNM.0000000000000847 DB - PRIME DP - Unbound Medicine ER -