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Diagnostic Accuracy of C-11 Choline and C-11 Acetate for Lymph Node Staging in Patients With Bladder Cancer: A Systematic Review and Meta-Analysis

Diagnostic Accuracy of C-11 Choline and C-11 Acetate for Lymph Node Staging in Patients With Bladder Cancer: A Systematic Review and Meta-Analysis

Seong-Jang Kim, Phillip J Koo, Kyoungjune Pak, In-Ju Kim, Keunyoung Kim

World J Urol. 2018 Mar;36(3):331-340.

PMID: 29294164

Abstract:

Objective:
We aimed to assess the diagnostic accuracy of C-11 choline and C-11 acetate positron emission tomography/computed tomography (PET/CT) for lymph node (LN) staging in bladder cancer (BC) patients through a systematic review and meta-analysis.
Methods:
The MEDLINE, EMBASE, and Cochrane Library database, from the earliest available date of indexing through June 30, 2017, were searched for studies evaluating the diagnostic performance of C-11 choline and C-11 acetate PET/CT for LN staging in BC. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic curves.
Results:
Across 10 studies (282 patients), the pooled sensitivity was 0.66 (95% CI 0.54-0.75) without heterogeneity (χ2 = 12.4, p = 0.19) and a pooled specificity of 0.89 (95% CI 0.76-0.95) with heterogeneity (χ2 = 29.1, p = 0.00). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 5.8 (95% CI 2.7-12.7) and negative likelihood ratio (LR-) of 0.39 (95% CI 0.28-0.53). The pooled diagnostic odds ratio (DOR) was 15 (95% CI 6-38). In meta-regression analysis, the study design (prospective vs retrospective) was the source of the study heterogeneity.
Conclusion:
C-11 choline and C-11 acetate PET/CT shows a low sensitivity and moderate specificity for the detection of metastatic LNs in patients with BC. Moreover, heterogeneity among the studies should be considered a limitation. Further large multicenter studies would be necessary to substantiate the diagnostic accuracy of C-11 choline and C-11 acetate PET/CT for this purpose.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP14586357	Cholin acetate		14586-35-7	Price

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