PMID- 32871859
OWN - NLM
STAT- MEDLINE
DCOM- 20200914
LR  - 20221005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 99
IP  - 35
DP  - 2020 Aug 28
TI  - Comparison of magnetic resonance imaging and 18-fludeoxyglucose positron emission 
      tomography/computed tomography in the diagnostic accuracy of staging in patients 
      with cholangiocarcinoma: A meta-analysis.
PG  - e20932
LID - 10.1097/MD.0000000000020932 [doi]
LID - e20932
AB  - BACKGROUND: Accurate clinical staging of patients with cholangiocarcinoma (CCA) 
      has a significant impact on treatment decisions. In this study, we aimed to 
      compare the diagnostic value of magnetic resonance imaging (MRI) and 
      18-fludeoxyglucose positron emission tomography/computed tomography (F-FDG 
      PET/CT) for staging of CCA. METHODS: We performed comprehensive systematic search 
      in Web of Science (including MEDLINE) and Excerpta Medica Database for relevant 
      diagnostic studies in accordance with the preferred reporting items for 
      systematic reviews and meta-analysis statement. Based on data extracted from 
      patient-based analysis, we calculated the pooled sensitivity and specificity with 
      the 95% confidence intervals (CIs). In addition, the publication bias was 
      assessed by Deek funnel plot of the asymmetry test. The potential heterogeneity 
      was explored by threshold effect analysis and subgroup analyses. RESULTS: 
      Thirty-two studies with 1626 patients were included in present analysis. In T 
      stage, the pooled sensitivity and specificity of MRI were 0.90 (95% CI 
      0.86-0.93), 0.84 (95% CI 0.73-0.91) respectively. The pooled sensitivity and 
      specificity of F-FDG PET/CT were 0.91 (95% CI 0.83-0.95) and 0.85 (0.64-0.95) 
      respectively. In N stage, the pooled sensitivity and specificity of MRI were 0.64 
      (95% CI 0.52-0.74) and 0.69 (95% CI 0.51-0.87) respectively. The pooled 
      sensitivity and specificity of PET/CT were 0.52 (95% CI 0.37-0.66) and 0.92 (95% 
      CI 0.79-0.97) respectively. In M stage, the pooled sensitivity and specificity of 
      F-FDG PET/CT were 0.56 (95% CI, 0.42-0.69) and 0.95 (95% CI, 0.91-0.97) 
      respectively. The Deek test revealed no significant publication bias. No 
      threshold effect was identified. The subgroup analyses showed that pathological 
      type (extrahepatic cholangiocarcinoma vs hilar cholangiocarcinoma/intrahepatic 
      cholangiocarcinoma), country (Asia vs non-Asia) and type of MRI (1.5T vs. 3.0T) 
      were potential causes for the heterogeneity of MRI studies and country (Asia vs 
      non-Asia) was a potential source for F-FDG PET/CT studies. CONCLUSION: The 
      analysis suggested that both modalities provide reasonable diagnostic accuracy in 
      T stage without significant differences between them. We recommend that both 
      modalities be considered based on local availability and practice for the 
      diagnosis of primary CCA tumors. In N stage, the diagnosis of lymph node 
      metastasis (N) of CCA is still limited by MRI and F-FDG PET/CT, due to 
      unsatisfactory diagnostic accuracy of both. Nevertheless, F-FDG PET/CT can be 
      used to confirm lymph node metastasis while a negative result may not rule out 
      metastasis. Furthermore, F-FDG PET/CT have a low sensitivity and a high 
      specificity for detection of distant metastasis.
FAU - Huang, Xujian
AU  - Huang X
AD  - Department of Hepatocellular Surgery, Affiliated Hospital of North Sichuan 
      Medical College.
AD  - Institute of Hepato-Biliary-Pancreatic-Intestinal Disease, North Sichuan Medical 
      College, Nanchong, China.
FAU - Yang, Jialin
AU  - Yang J
AD  - Department of Radiology, Nanchong Central Hospital/Second School of Clinical 
      Medicine.
AD  - Institute of Hepato-Biliary-Pancreatic-Intestinal Disease, North Sichuan Medical 
      College, Nanchong, China.
FAU - Li, Jingdong
AU  - Li J
AD  - Department of Hepatocellular Surgery, Affiliated Hospital of North Sichuan 
      Medical College.
AD  - Institute of Hepato-Biliary-Pancreatic-Intestinal Disease, North Sichuan Medical 
      College, Nanchong, China.
FAU - Xiong, Yongfu
AU  - Xiong Y
AUID- ORCID: 0000-0003-0245-0382
AD  - Department of Hepatocellular Surgery, Affiliated Hospital of North Sichuan 
      Medical College.
AD  - Institute of Hepato-Biliary-Pancreatic-Intestinal Disease, North Sichuan Medical 
      College, Nanchong, China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
SB  - IM
MH  - Aged
MH  - Bile Duct Neoplasms/*pathology
MH  - Cholangiocarcinoma/*diagnostic imaging/epidemiology
MH  - Female
MH  - Fluorodeoxyglucose F18/administration & dosage
MH  - Humans
MH  - Lymphatic Metastasis/diagnostic imaging/pathology
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Multimodal Imaging/methods
MH  - Neoplasm Staging/methods
MH  - Positron-Emission Tomography/*methods
MH  - Sensitivity and Specificity
MH  - Tomography, X-Ray Computed/methods
PMC - PMC7458197
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2020/09/03 06:00
MHDA- 2020/09/15 06:00
PMCR- 2020/08/28
CRDT- 2020/09/03 06:00
PHST- 2020/09/03 06:00 [entrez]
PHST- 2020/09/03 06:00 [pubmed]
PHST- 2020/09/15 06:00 [medline]
PHST- 2020/08/28 00:00 [pmc-release]
AID - 00005792-202008280-00002 [pii]
AID - MD-D-20-00185 [pii]
AID - 10.1097/MD.0000000000020932 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2020 Aug 28;99(35):e20932. doi: 
      10.1097/MD.0000000000020932.