Page 152 - Quantitative Imaging of Small Tumours with Positron Emission Tomography
P. 152
subgroups, overall measures of accuracy were calculated when possible. When p-values of differences in accuracy between uncorrected and PVC data were not reported, these differences were deemed not statistically significant. Descriptive data regarding cancer type, number of patients, lesion sizes, scanner type, and PVC method were also extracted. Unless stated otherwise, we presented data on SUV quantification. Diagnostic studies on the same topic were pooled using bivariate random effects meta-regression analysis, which is the recommended method for meta- analysis of diagnostic studies (13). This method provides summary estimates of sensitivity and specificity with 95% confidence intervals, taking into account the correlation between sensitivity and specificity and heterogeneity in results between studies. We tested for differences in overall diagnostic accuracy between different diagnostic tests using a likelihood ratio test, comparing models that included and excluded a covariate for the diagnostic test. For illustrative purposes, summary receiver-operator-characteristics (ROC) curves were calculated according to the Moses-Littenberg method (14). We used Stata software (StataCorp. 2015. Stata Statistical Software: Release 14. College Station, TX: StataCorp LP.) for statistical analyses. Results 7 Study selection Pubmed and EMBASE searches yielded 371 potentially eligible studies (Figure 7.1). Three studies were additionally found through reference screening. Two-hundred and ninety-three abstracts were excluded based on eligibility criteria, leaving 81 for full-text screening. For 19 (5.1%) abstracts, judgments were conflicting, which were resolved through discussion. After full-text reviewing, 31 studies met eligibility criteria (Figure 7.1). Studies on diagnosis (n=10), staging (n=10), prognostication (n=6), and response assessment (n=5) are presented in Tables 7.1- 7.4, respectively. Supplemental Table 3 contains the PVC and tumour delineation methodologies, reconstruction settings, full-width at half maximums, and voxel- sizes of each included study. Thirty studies used 18F-FDG as radiopharmaceutical, one study used 18F-Choline. Systematic review and meta-analysis 151