Diagnostic accuracy of 18F-FDG PET or PET/CT for the characterization of adrenal masses: a systematic review and meta-analysis
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Objective: We aimed to explore the role of the diagnostic accuracy of 18F fluodeoxyglucose PET (18F-FDG PET) or PET/CT for characterization of adrenal lesions through a systematic review and meta-analysis. Methods: The MEDLINE, EMBASE, and Cochrane Library database, from the earliest available date of indexing through 30 April 2017, were searched for studies evaluating the diagnostic performance of 18F-FDG PET or PET/CT for characterization of adrenal lesions. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR + and LR–), and constructed summary receiver operating characteristic curves. Results: Across 29 studies (2421 patients), the pooled sensitivity for 18F-FDG PET or PET/CT was 0.91 [95% CI (0.88–0.94)] with heterogeneity (χ 2 = 141.8, p = 0.00) and a pooled specificity of 0.91 [95% CI (0.87–0.93)] with heterogeneity (χ 2 = 113.7, p = 0.00). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 9.9 [95% CI (7.1–13.7)] and negative likelihood ratio (LR–) of 0.09 [95% CI (0.07–0.13)]. The pooled diagnostic odds ratio was 105 [95% CI (63–176)]. In metaregression analysis, study design, publication year, study location (western vs others), interpretation criteria of PET or PET/CT images, quantification of PET or PET/CT [SUVmax (maximum standardized uptake value) vs SUV (standardized uptake value) ratio], patient group, and analysis method (patient-based vs lesion-based) were the sources of the study heterogeneity. However, in multivariate metaregression, no definite variable was the source of the study heterogeneity. Conclusion: 18F-FDG PET or PET/CT demonstrated good sensitivity and specificity for the characterization of adrenal masses. At present, the literature regarding the use of 18F-FDG PET or PET/CT for the characterization of adrenal masses remains still limited; thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of 18F-FDG PET or PET/CT characterization of adrenal masses. Advances in knowledge: 18F- FDG PET or PET/CT showed good sensitivity and specificity for the characterization of adrenal masses and could provide additional information for that purpose.
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FDG PET-CT has pooled sensitivity 91% and specificity 91% for characterization of adrenal masses in a meta-analysis of 29 studies (2421 patients).
“FDG PET-CT has high diagnostic accuracy for characterization of adrenal masses with a pooled sensitivity of 91% and specificity of 91% in a recent meta-analysis of 29 studies involving 2421 patients (311).”
From Adrenal incidentaloma (2020) · cites this paper as [311]
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- Authors
- Kim, S.-J., Lee, S.-W., Pak, K., Kim, I.-J., & Kim, K.
- Affiliations
- Pusan National University Yangsan Hospital (KR)
- Kyungpook National University (KR)
- Pusan National University Hospital (KR)
- Venue
- The British Journal of Radiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-02-05
- Volume
- 91
- Issue
- 1086
- Pages
- 20170520-20170520
- ISSN
- 0007-1285 (ISSN-L)
- 1748-880X
- PMC
- PMC6223272
- OpenAlex
- W2783166877
- Cited by
- 76
- References
- 58
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 16 · 2023: 10 · 2022: 12 · 2021: 12 · 2020: 7 · 2019: 4 · 2018: 2
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- British Journal of Radiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Keywords
- PET/CT, adrenal mass, diagnostic accuracy, sensitivity and specificity, standardized uptake value, adrenal incidentaloma, adrenal tumors, likelihood ratios, study heterogeneity, adrenal metastasis, adrenal pheochromocytoma
- MeSH terms
- Positron Emission Tomography Computed Tomography, Adenoma, Adrenal Gland Neoplasms, Humans, Sensitivity and Specificity, Radiopharmaceuticals, Fluorodeoxyglucose F18, Positron-Emission Tomography
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