Diagnostic performance of imaging for the detection of peritoneal metastases: a meta-analysis

H.P. van't Sant*, M. P. Engbersen, P. A. Bhairosing, D. M. J. Lambregts, R. G. H. Beets-Tan, W. J. van Driel, A. G. J. Aalbers, N. F. M. Kok, M. J. Lahaye

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

32 Citations (Web of Science)

Abstract

Purpose Detection of peritoneal metastases (PM) is key in the staging and management of gastrointestinal and ovarian cancer patients. The purpose of this meta-analysis was to determine the diagnostic performance of CT, PET(CT), and (DW)MRI in detecting PM. Methods A literature search in Pubmed, Embase (Ovid), and Scopus was performed (January 1997-May 2018) to identify studies reporting on the accuracy of imaging PM in the diagnostic workup of gastrointestinal or ovarian cancers. Inclusion criteria were region-based or patient-based studies comprising > 15 patients, surgery/histology/radiological follow-up as a reference standard, and sufficient data to construct a 2 x 2 contingency table. Two observers performed data extraction. The sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated using a bivariate random-effects model and hierarchical summary operating curves (HSROC) were generated. Results Of 3457 citations retrieved, twenty-four articles met all inclusion criteria. Thirty-seven datasets could be extracted for analysis including 20 for CT, 10 for PET(CT), and 7 for (DW)MRI. The pooled sensitivity, specificity, and DOR for the detection of PM for region-based studies for CT were 68% (CI, 46-84%), 88%(CI, 81-93%), and 15.9 (CI, 4.4-58.0) respectively; 80% (CI, 57-92%), 90% (CI, 80-96%), and 36.5 (CI, 6.7-199.5) for PET(CT), respectively; 92% (CI, 84-96%), 85% (CI, 78-91%), 63.3 (CI, 31.5-127.3) for (DW)MRI. In the patient-based group, not enough studies were included to make a pooled analysis for (DW)MRI and PET(CT). Conclusion (DW)MRI and PET(CT) showed comparable diagnostic performance for the detection of peritoneal metastases in ovarian and gastrointestinal cancer patients. Since MRI is more widely available than PET(CT) in clinical practice, this potentially is the imaging method of choice in most centers in the future.

Original languageEnglish
Pages (from-to)3101-3112
Number of pages12
JournalEuropean Radiology
Volume30
Issue number6
DOIs
Publication statusPublished - Jun 2020

Keywords

  • Peritoneal neoplasms
  • Spiral computed tomography
  • Magnetic resonance imaging
  • Positron emission tomography computed tomography
  • HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY
  • DIFFUSION-WEIGHTED SEQUENCE
  • ADVANCED OVARIAN-CANCER
  • WHOLE-BODY MRI
  • CYTOREDUCTIVE SURGERY
  • COMPUTED-TOMOGRAPHY
  • ENHANCED CT
  • CARCINOMATOSIS
  • PET/CT
  • IMPROVEMENT

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