Comparing the diagnostic efficacy of [18F]FDG PET/CT and MRI in the initial diagnosis of ovarian cancer: a meta-analysis.

ABSTRACT

PURPOSE: This meta-analysis was conducted to assess the relative diagnostic effectiveness of [18F]FDG PET/CT and MRI in the initial detection of ovarian cancer. METHODS: A thorough literature search was conducted using PubMed, Embase, and Web of Science databases to locate relevant studies published up to April 2024. The selected studies were those that evaluated diagnostic performance of [18F]FDG PET/CT and MRI for the initial detection of ovarian cancer. Sensitivity and specificity metrics were analyzed employing the DerSimonian and Laird random-effects model, with further transformation utilizing the Freeman-Tukey double arcsine method. The quality of included studies was appraised using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. RESULTS: The meta-analysis included 23 articles encompassing a total of 1973 patients. The sensitivity of [18F]FDG PET/CT was found to be higher than that of MRI (0.94 vs. 0.87, P = 0.02). In terms of specificity, [18F]FDG PET/CT and MRI demonstrated similar values (0.87 vs. 0.86, P = 0.90). An assessment of publication bias using the funnel plot asymmetry test revealed no significant bias for any outcomes (Egger's test all P > 0.05). CONCLUSIONS: Our meta-analysis reveals that [18F]FDG PET/CT exhibits higher sensitivity while maintaining similar specificity compared to MRI for the initial detection of ovarian cancer. However, the substantial heterogeneity observed across studies may influence these findings. Consequently, larger-scale prospective studies are necessary to validate these results.