Diagnostic performance of 18F-FDG PET or PET/CT in restaging renal cell carcinoma: a systematic review and meta-analysis

Nucl Med Commun. 2017 Feb;38(2):156-163. doi: 10.1097/MNM.0000000000000618.


Background: In recent years, fluorine-18-fluorodeoxyglucose (F-FDG) PET or PET/computed tomography (PET/CT) has emerged as a valuable method for restaging of cancer. The aim of this study was to evaluate its diagnostic performance for detecting metastatic or recurrent lesions in patients with renal cell carcinoma (RCC).

Methods: Several databases were searched for relevant articles on F-FDG PET or PET/CT for the restaging of RCC. Two researchers independently selected studies, extracted data, and assessed the methodological quality according to the QUADAS-2 tool. On a per-patient basis, we determined the pooled sensitivity, specificity, diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio. Summary receiver-operating characteristic curves were also constructed with the area under the curve and Q* index obtained.

Results: A total of 15 studies involving 1168 patients fulfilled the inclusion criteria. After excluding one study on the basis of the sensitivity analysis, the pooled estimates of 14 studies were 0.86 [95% confidence interval (CI), 0.88-0.93] for sensitivity, 0.88 (95% CI, 0.84-0.91) for specificity, 5.85 (95% CI, 4.27-8.03) for positive likelihood ratio, 0.18 (95% CI, 0.12-0.26) for negative likelihood ratio, and 42.12 (95% CI, 21.56-82.28) for diagnostic odds ratio. The area under the curve and Q* estimates were 0.9310 and 0.8663, respectively.

Conclusions: Current evidence suggests that F-FDG PET or PET/CT is a valuable tool in the detection of metastatic or recurrent lesions in patients with RCC. More prospective studies on PET or PET/CT in the restaging of RCC are still needed.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Carcinoma, Renal Cell / diagnostic imaging*
  • Carcinoma, Renal Cell / pathology
  • Female
  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Humans
  • Kidney Neoplasms / diagnostic imaging*
  • Kidney Neoplasms / pathology
  • Male
  • Neoplasm Staging
  • Positron Emission Tomography Computed Tomography* / statistics & numerical data
  • Positron-Emission Tomography* / statistics & numerical data
  • Radiopharmaceuticals
  • Sensitivity and Specificity


  • Fluorine Radioisotopes
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18