Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer: a systematic review and meta-analysis

Lucas Goense; Jihane Meziani; Peter S N van Rossum; Frank J Wessels; Gert J Meijer; Marnix G E H Lam; Richard van Hillegersberg; Jelle P Ruurda

doi:10.1097/MNM.0000000000000847

Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer: a systematic review and meta-analysis

Lucas Goense, Jihane Meziani, Peter S N van Rossum, Frank J Wessels, Gert J Meijer, Marnix G E H Lam, Richard van Hillegersberg, Jelle P Ruurda

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective To assess the additional value of cervical ultrasonography as supplement to a negative fluorine- 18-fluorodeoxyglucose ( ¹⁸F-FDG) PET/computed tomography (CT) for detecting cervical lymph node metastases during the initial staging of patients with esophageal cancer. Methods PubMed/Medline, Embase, and the Cochrane library were systematically searched. The analysis included diagnostic studies describing the accuracy of cervical ultrasonography and integrated ¹⁸F-FDG PET/CT or standalone ¹⁸F-FDG PET and CT for detecting cervical lymph node metastases in patients with esophageal cancer. The reference standard consisted of cytopathology and/or clinical follow-up. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the quality of the included studies. A random effects model was used to meta-analyze the additional diagnostic value of cervical ultrasonography. Results Four diagnostic studies were eligible and included for meta-analysis, comprising 567 patients with esophageal cancer who underwent diagnostic workup before treatment. The quality of the included studies was considered reasonable; there were few concerns regarding risk of bias and applicability. In three of the four studies, cervical ultrasonography did not detect cervical lymph node metastases in addition to a negative finding on ¹⁸F-FDG PET/CT or standalone ¹⁸F-FDG PET and CT. In one study, cervical ultrasonography detected additional cervical lymph node metastases in 4% (3/74) of patients over standalone ¹⁸F-FDG PET and CT. Pooled estimate of the additional value of cervical ultrasonography was 1% (95% confidence interval: 0-5%). Conclusion Cervical ultrasonography has very limited additional diagnostic value as supplement to a negative ¹⁸F-FDG PET/CT in the detection of cervical lymph node metastases during the initial staging of patients with esophageal cancer.

Original language	English
Pages (from-to)	645-651
Number of pages	7
Journal	Nuclear Medicine Communications
Volume	39
Issue number	7
DOIs	https://doi.org/10.1097/MNM.0000000000000847
Publication status	Published - 2018

Keywords

cancer staging
cervical lymph node metastases
cervical ultrasonography
esophageal cancer
fluorine-18-fluorodeoxyglucose PET/computed tomography

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10.1097/MNM.0000000000000847

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Goense, L., Meziani, J., van Rossum, P. S. N., Wessels, F. J., Meijer, G. J., Lam, M. G. E. H., van Hillegersberg, R., & Ruurda, J. P. (2018). Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer: a systematic review and meta-analysis. Nuclear Medicine Communications, 39(7), 645-651. https://doi.org/10.1097/MNM.0000000000000847

@article{bb3573b98304403c93e486230940c581,

title = "Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer: a systematic review and meta-analysis",

abstract = "Objective To assess the additional value of cervical ultrasonography as supplement to a negative fluorine- 18-fluorodeoxyglucose ( 18F-FDG) PET/computed tomography (CT) for detecting cervical lymph node metastases during the initial staging of patients with esophageal cancer. Methods PubMed/Medline, Embase, and the Cochrane library were systematically searched. The analysis included diagnostic studies describing the accuracy of cervical ultrasonography and integrated 18F-FDG PET/CT or standalone 18F-FDG PET and CT for detecting cervical lymph node metastases in patients with esophageal cancer. The reference standard consisted of cytopathology and/or clinical follow-up. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the quality of the included studies. A random effects model was used to meta-analyze the additional diagnostic value of cervical ultrasonography. Results Four diagnostic studies were eligible and included for meta-analysis, comprising 567 patients with esophageal cancer who underwent diagnostic workup before treatment. The quality of the included studies was considered reasonable; there were few concerns regarding risk of bias and applicability. In three of the four studies, cervical ultrasonography did not detect cervical lymph node metastases in addition to a negative finding on 18F-FDG PET/CT or standalone 18F-FDG PET and CT. In one study, cervical ultrasonography detected additional cervical lymph node metastases in 4% (3/74) of patients over standalone 18F-FDG PET and CT. Pooled estimate of the additional value of cervical ultrasonography was 1% (95% confidence interval: 0-5%). Conclusion Cervical ultrasonography has very limited additional diagnostic value as supplement to a negative 18F-FDG PET/CT in the detection of cervical lymph node metastases during the initial staging of patients with esophageal cancer.",

keywords = "cancer staging, cervical lymph node metastases, cervical ultrasonography, esophageal cancer, fluorine-18-fluorodeoxyglucose PET/computed tomography",

author = "Lucas Goense and Jihane Meziani and {van Rossum}, {Peter S N} and Wessels, {Frank J} and Meijer, {Gert J} and Lam, {Marnix G E H} and {van Hillegersberg}, Richard and Ruurda, {Jelle P}",

note = "Publisher Copyright: {\textcopyright} 2018 Wolters Kluwer Health, Inc.",

year = "2018",

doi = "10.1097/MNM.0000000000000847",

language = "English",

volume = "39",

pages = "645--651",

journal = "Nuclear Medicine Communications",

issn = "0143-3636",

publisher = "Lippincott Williams & Wilkins",

number = "7",

}

Goense, L, Meziani, J, van Rossum, PSN, Wessels, FJ, Meijer, GJ , Lam, MGEH , van Hillegersberg, R & Ruurda, JP 2018, 'Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer: a systematic review and meta-analysis', Nuclear Medicine Communications, vol. 39, no. 7, pp. 645-651. https://doi.org/10.1097/MNM.0000000000000847

Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer: a systematic review and meta-analysis. / Goense, Lucas; Meziani, Jihane; van Rossum, Peter S N et al.
In: Nuclear Medicine Communications, Vol. 39, No. 7, 2018, p. 645-651.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer

T2 - a systematic review and meta-analysis

AU - Goense, Lucas

AU - Meziani, Jihane

AU - van Rossum, Peter S N

AU - Wessels, Frank J

AU - Meijer, Gert J

AU - Lam, Marnix G E H

AU - van Hillegersberg, Richard

AU - Ruurda, Jelle P

PY - 2018

Y1 - 2018

N2 - Objective To assess the additional value of cervical ultrasonography as supplement to a negative fluorine- 18-fluorodeoxyglucose ( 18F-FDG) PET/computed tomography (CT) for detecting cervical lymph node metastases during the initial staging of patients with esophageal cancer. Methods PubMed/Medline, Embase, and the Cochrane library were systematically searched. The analysis included diagnostic studies describing the accuracy of cervical ultrasonography and integrated 18F-FDG PET/CT or standalone 18F-FDG PET and CT for detecting cervical lymph node metastases in patients with esophageal cancer. The reference standard consisted of cytopathology and/or clinical follow-up. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the quality of the included studies. A random effects model was used to meta-analyze the additional diagnostic value of cervical ultrasonography. Results Four diagnostic studies were eligible and included for meta-analysis, comprising 567 patients with esophageal cancer who underwent diagnostic workup before treatment. The quality of the included studies was considered reasonable; there were few concerns regarding risk of bias and applicability. In three of the four studies, cervical ultrasonography did not detect cervical lymph node metastases in addition to a negative finding on 18F-FDG PET/CT or standalone 18F-FDG PET and CT. In one study, cervical ultrasonography detected additional cervical lymph node metastases in 4% (3/74) of patients over standalone 18F-FDG PET and CT. Pooled estimate of the additional value of cervical ultrasonography was 1% (95% confidence interval: 0-5%). Conclusion Cervical ultrasonography has very limited additional diagnostic value as supplement to a negative 18F-FDG PET/CT in the detection of cervical lymph node metastases during the initial staging of patients with esophageal cancer.

AB - Objective To assess the additional value of cervical ultrasonography as supplement to a negative fluorine- 18-fluorodeoxyglucose ( 18F-FDG) PET/computed tomography (CT) for detecting cervical lymph node metastases during the initial staging of patients with esophageal cancer. Methods PubMed/Medline, Embase, and the Cochrane library were systematically searched. The analysis included diagnostic studies describing the accuracy of cervical ultrasonography and integrated 18F-FDG PET/CT or standalone 18F-FDG PET and CT for detecting cervical lymph node metastases in patients with esophageal cancer. The reference standard consisted of cytopathology and/or clinical follow-up. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the quality of the included studies. A random effects model was used to meta-analyze the additional diagnostic value of cervical ultrasonography. Results Four diagnostic studies were eligible and included for meta-analysis, comprising 567 patients with esophageal cancer who underwent diagnostic workup before treatment. The quality of the included studies was considered reasonable; there were few concerns regarding risk of bias and applicability. In three of the four studies, cervical ultrasonography did not detect cervical lymph node metastases in addition to a negative finding on 18F-FDG PET/CT or standalone 18F-FDG PET and CT. In one study, cervical ultrasonography detected additional cervical lymph node metastases in 4% (3/74) of patients over standalone 18F-FDG PET and CT. Pooled estimate of the additional value of cervical ultrasonography was 1% (95% confidence interval: 0-5%). Conclusion Cervical ultrasonography has very limited additional diagnostic value as supplement to a negative 18F-FDG PET/CT in the detection of cervical lymph node metastases during the initial staging of patients with esophageal cancer.

KW - cancer staging

KW - cervical lymph node metastases

KW - cervical ultrasonography

KW - esophageal cancer

KW - fluorine-18-fluorodeoxyglucose PET/computed tomography

U2 - 10.1097/MNM.0000000000000847

DO - 10.1097/MNM.0000000000000847

M3 - Article

C2 - 29672463

SN - 0143-3636

VL - 39

SP - 645

EP - 651

JO - Nuclear Medicine Communications

JF - Nuclear Medicine Communications

IS - 7

ER -

Limited additional value of cervical ultrasonography over a negative 18F-FDG PET/CT for diagnosing cervical lymph node metastases in patients with esophageal cancer: a systematic review and meta-analysis

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Keywords

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