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Quartuccio et al. J Cancer Metastasis Treat 2021;7:14 Journal of Cancer
DOI: 10.20517/2394-4722.2020.118 Metastasis and Treatment

Review Open Access

Role of F-FDG PET/CT in detection of
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hematogenous metastases of advanced

differentiated thyroid carcinoma: a systematic
review and meta-analysis

Natale Quartuccio , Domenico Rubello 2
1
1 Nuclear Medicine Unit, A.R.N.A.S. Civico, Di Cristina and Benfratelli Hospitals, Palermo 90144, Italy.
2 Nuclear Medicine Unit, Santa Maria della Misericordia Hospital, Rovigo 45100, Italy.
Correspondence to: Dr. Domenico Rubello, Nuclear Medicine Department, Santa Maria della Misericordia Hospital, Rovigo
45100, Italy. E-mail: domenico.rubello@libero.it
How to cite this article: Quartuccio N, Rubello D. Role of F-FDG PET/CT in detection of hematogenous metastases of advanced
18
differentiated thyroid carcinoma: a systematic review and meta-analysis. J Cancer Metastasis Treat 2021;7:14.
http://dx.doi.org/10.20517/2394-4722.2020.118

Received: 29 Oct 2020 First Decision: 22 Dec 2020 Revised: 4 Jan 2021 Accepted: 23 Feb 2021 Published: 18 Mar 2021
Academic Editor: Jerome M. Hershman Copy Editor: Yue-Yue Zhang Production Editor: Xi-Jun Chen

Abstract
The aim of this study was to collect the evidence on the performance of 2-deoxy-2-[18F]fluoro-D-glucose
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( F-FDG) Positron Emission Tomography/Computed Tomography (PET/CT) in terms of detection rate (DR) and
diagnostic accuracy in identifying hematogenous metastases in patients with differentiated thyroid cancer and
compare its performance with that of other imaging techniques. A comprehensive PubMed/MEDLINE database
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research was carried out to retrieve studies documenting the performance of F-FDG PET/CT in depicting
hematogenous metastases in patients with differentiated thyroid cancer. Statistical analysis was performed on a
per-patient and per-lesion basis. The literature search yielded 15 articles to be included in the systematic review.
18 F-FDG PET/CT showed a pooled DR of 85.08% on a per-patient analysis and 89.70% on a per-lesion analysis.
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For bone lesions, a high DR (81.78%) was found for F-FDG PET/CT. For the sub-group analysis of lung lesions,
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pooled DR was 92.77% for F-FDG PET/CT, 95.02% for CT, and 64.93% for magnetic resonance imaging (MRI).
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On a per-patient analysis, F-FDG PET/CT demonstrated a pooled sensitivity (SS) of 87.3% [95% confidence
interval (CI): 77.3%-94%] and a pooled specificity (SP) of 95.6% (95%CI: 87.6-99.1). On a per-lesion analysis
(328 metastases), PET/CT showed a pooled SS and SP of 86.3% (95%CI: 73.5%-93.5%) and 93.4% (95%CI:
71.7%-98.8%) in the detection of hematogenous metastases. The presented systematic review and meta-analysis
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favor the use of F-FDG PET/CT in the detection of hematogenous metastases in patients with differentiated
thyroid cancer. The limited literature warrants further studies to confirm our findings.

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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