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Diagnostic performance of F-18 FDG PET/CT for prediction of KRAS mutation in colorectal cancer patients: a systematic review and meta-analysis

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Abstract

Objective

The purpose of the current study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the prediction of v-Ki-ras-2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation in colorectal cancer (CRC) patients through a systematic review and meta-analysis.

Methods

The PubMed and EMBASE database, from the earliest available date of indexing through April 30, 2018, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for prediction of KRAS mutation in CRC patients.

Results

Across 9 studies (804 patients), the pooled sensitivity for F-18 FDG PET/CT was 0.66 (95% CI 0.60–0.73) without heterogeneity (I2 = 34.1, p = 0.14) and a pooled specificity of 0.67 (95% CI 0.62–0.72) without heterogeneity (I2 = 1.63, p = 0.42). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 2.0 (95% CI 1.7–2.4) and negative likelihood ratio (LR−) of 0.5 (95% CI 0.41–0.61). The pooled diagnostic odds ratio (DOR) was 4 (95% CI 3–6). Hierarchical summary receiver operating characteristic (ROC) curve indicates that the areas under the curve were 0.69 (95% CI 0.65–0.73).

Conclusion

The current meta-analysis showed the low sensitivity and specificity of F-18 FDG PET/CT for prediction of KRAS mutation in CRC patients. The DOR was very low and the likelihood ratio scatter-gram indicated that F-18 FDG PET/CT might not be useful for prediction of KRAS mutation and not for its exclusion. Therefore, cautious application and interpretation should be paid to the F-18 FDG PET/CT for prediction of KRAS mutation in CRC patients.

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Funding

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

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Authors and Affiliations

  1. Department of Nuclear Medicine, College of Medicine, Pusan National University Yangsan Hospital, Yangsan, 50612, South Korea

    Seong-Jang Kim

  2. BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, 50612, South Korea

    Seong-Jang Kim

  3. Department of Nuclear Medicine, Pusan National University Hospital, Busan, South Korea

    Kyoungjune Pak & Keunyoung Kim

Authors
  1. Seong-Jang Kim
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  2. Kyoungjune Pak
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Contributions

Kim SJ and Pak K contributed in protocol/project development. Kim SJ, Kim K, and Pak K contributed in data collection or management. Kim SJ and Kim K contributed in data analysis. Kim SJ, Pak K, and Kim K contributed in manuscript writing/editing.

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Correspondence to Seong-Jang Kim.

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Conflict of interest

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of this study.

Ethical approval

Institutional review board approval was not required because we only performed data analysis based on the published studies.

Informed consent

Written informed consent was not required for this study because it is a meta-analysis based on the studies that have been published.

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Kim, SJ., Pak, K. & Kim, K. Diagnostic performance of F-18 FDG PET/CT for prediction of KRAS mutation in colorectal cancer patients: a systematic review and meta-analysis. Abdom Radiol 44, 1703–1711 (2019). https://doi.org/10.1007/s00261-018-01891-3

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