A meta-analysis of the literature for whole-body FDG PET detection of recurrent colorectal cancer

A meta-analysis of the literature for the use of FDG PET in the detection o f recurrent colorectal cancer (CRC) was conducted to evaluate the quality o f the reported stud ies. Overall values for the sensitivity and specificity of whole-body FDG PET and an overall FDG PET-directed percentage change in management were also determined through this analysis. Methods: Guidelines to evaluate the articles were formulated on the basis of the U.S. medical payer source criteria for assessing studies that report information on usag e of new medical technology. A metaanalysis was conducted using methodology described in the peer-reviewed literature. Results: On the basis of the gu idelines established for our review, the availability of necessary informat ion for assessing the reliability of the FDG PET data for diagnosing recurr ent CRC was less than ideal. Through a meta-analysis of 11 articles, we det ermined, within a 95% confidence level, an overall sensitivity of 97% (95% confidence level, 95%-99%) and an overall specificity of 76% (95% confidenc e level, 64%-88%) for FDG PET detecting recurrent CRC throughout the whole body. Furthermore, through pooling of the change-in-management data, an ove rall FDG PET-directed change in management was calculated to be 29% (95% co nfidence level, 25%-34%). Conclusion: Our review suggests that improvements can be made to more effectively report the results of these FDG PET studie s. The overall values determined through the meta-analysis indicate the pot ential benefits of using FDG PET as a diagnostic or management tool. Furthe rmore, these Values should prove to be useful to assess the cost-effectiven ess of using FDG PET in the management of patients with recurrent CRC.