The Diagnostic Accuracy of PET(CT) in Patients With Neuroblastoma: A Meta-Analysis and Systematic Review

Objective The objective of this study was to evaluate the overall diagnostic value of PET(CT) in patients with neuroblastoma (NB) based on qualified studies. Methods PubMed, Cochrane, and Embase database were searched by the index words to identify the qualified studies, and relevant literature sources were also searched. The latest research was performed in April 2019. Heterogeneity of the included studies was tested, which was used to select proper effect model to calculate pooled weighted sensitivity, specificity, and diagnostic odds ratio (DOR). Summary receiver operating characteristic (SROC) analyses were also performed. Results Eleven studies with 580 patients were involved in the meta-analysis to explore the diagnostic accuracy of PET(CT) for NB. PET(CT) has high diagnostic accuracy of NB: the global sensitivity was 91% (95% confidence interval [CI], 86%–94%), the global specificity was 78% (95% CI, 66%–86%), the global positive likelihood ratio was 4.07 (95% CI, 2.54–6.50), the global negative likelihood ratio was 0.12 (95% CI, 0.08–0.18), the global DOR was 27.43 (95% CI, 14.45–52.07), and the area under the SROC was high (area under the curve, 0.93; 95% CI, 0.90–0.95). Besides this, PET(CT) has high diagnostic accuracy of primary NB: the global sensitivity was 86% (95% CI, 73%–93%), the global specificity was 82% (95% CI, 57%–94%), the global positive likelihood ratio was 4.90 (95% CI, 1.63–14.72), the global negative likelihood ratio was 0.17 (95% CI, 0.07–0.40), the global DOR was 25.427 (95% CI, 3.988–162.098), and the area under the SROC was high (area under the curve, 0.91; 95% CI, 0.88–0.93). However, there has no significant accuracy of PET(CT) in NB with bone marrow. Conclusions This study provides a systematic review and meta-analysis of diagnostic accuracy studies of PET(CT) for NB. The results indicated that PET(CT) is a highly accurate diagnostic tool for NB.