Key result
18F-FDG PET/CT demonstrated high diagnostic accuracy for Ewing sarcoma, with 92.6% sensitivity and 74.1% specificity for total lesions, though CT remains superior for detecting lung metastasis.
Why the study?
The study was conducted to evaluate the diagnostic accuracy of 18 F-FDG PET and PET/CT in imaging primary and metastatic lesions in Ewing sarcoma.
Does 18F-FDG PET and PET/CT accurately diagnose primary and metastatic lesions in patients with Ewing sarcoma?
Meta-Analysis (n=735)
Does 18F-FDG PET and PET/CT accurately diagnose primary and metastatic lesions in patients with Ewing sarcoma?
18F-FDG PET/CT is a sensitive and accurate modality for diagnosing, staging, and detecting recurrence of Ewing sarcoma, though CT remains superior for lung metastases.
Supports PET/CT integration into Ewing sarcoma staging; extends Level 1 evidence for lesion evaluation.
Purpose The aim of this study was to evaluate the diagnostic accuracy of 18 ‐fluorodeoxyglucose‐positron emission tomography ( 18 F‐FDG PET) and PET/computed tomography (PET/CT) in imaging primary and metastatic lesions in Ewing sarcoma (ES). Methods PubMed, Cochrane, Scopus, and Web of Science were searched for relevant studies. Data concerning 18 F‐FDG PET/CT diagnostic accuracy were extracted and then analyzed using Open Meta‐analyst software. Reported diagnostic accuracy outcomes included sensitivity, specificity, negative likelihood ratio (NLR), positive likelihood ratio (PLR), and diagnostic odds ratio. Results Thirty‐one studies with a total of 735 patients were included in this meta‐analysis. The sensitivity and specificity of 18 F‐FDG PET/CT were: 92.6% and 74.1% for total ES lesions, 96.7% and 68.3% for ES primary lesions, 76.1% and 92.4% for lung metastasis, 83.9% and 93.2% for bone metastasis, and 89.9% and 92.6% for ES recurrence, respectively. Conclusion 18 F‐FDG PET/CT is sensitive and accurate in diagnosing, staging, and detecting the recurrence of ES compared with non‐PET imaging. It has high accuracy for diagnosing recurrence of ES in bone metastases; however, CT remains a superior diagnostic method for detecting lung metastasis.
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Seth et al. (2021) conducted a meta-analysis in Ewing sarcoma (n=735). 18F-FDG PET and PET/CT vs. non-PET imaging was evaluated on Diagnostic accuracy (sensitivity and specificity) for total Ewing sarcoma lesions. 18F-FDG PET/CT demonstrated high diagnostic accuracy for Ewing sarcoma, with 92.6% sensitivity and 74.1% specificity for total lesions, though CT remains superior for detecting lung metastasis.
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