Diagnostic efficacy of PET-CT, CT, and MRI in preoperative assessment of mandibular invasion caused by head and neck cancer: A systematic review and meta-analysis

Oral Oncol. 2021 May:116:105264. doi: 10.1016/j.oraloncology.2021.105264. Epub 2021 Mar 21.

Abstract

Objective: This study aims to conduct a systematic review and meta-analysis of the performance of PET-CT, CT, and MRI in diagnosing mandible invasion induced by head and neck cancer (HNC).

Materials and methods: The MEDLINE, Embase, Science Direct, CNKI and CQVIP databases were searched from inception until August 1, 2020. Then, a meta-analysis was conducted to calculate the combined diagnostic values with the corresponding 95% CIs. Two independent researchers completed the full text screening, data abstraction, and risk assessment.

Results: This meta-analysis included 53 studies (N = 2 946 participants). For the pooled sensitivity (SEN), MRI (SEN: 0.88, 95% CI: 0.81-0.93) was found to have a significantly higher SEN (P = 0.0045), when compared to CT (SEN: 0.77, 95% CI: 0.71-0.82), while compared with PET-CT (SEN: 0.88, 95% CI: 0.64-0.97), the SEN was approximately equal (P > 0.05). The analysis revealed that the combined specificity (SPE) of MRI (SPE: 0.83, 95% CI: 0.74-0.89) and PET-CT (SPE: 0.81, 95% CI: 0.57-0.93) was lower than that of CT (SPE: 0.87, 95% CI: 0.83-0.90), but there was no statistical significance among these (P > 0.05). The comparison of the area under curve (AUC) reflected that PET-CT, CT and MRI have approximately equal summary diagnostic power in detecting mandibular invasion (P > 0.05).

Conclusion: The findings suggest that compared with CT, MRI is significantly superior for higher SEN in diagnosing mandibular invasion. The SEN of MRI and PET-CT were approximately equal. For the summary of diagnostic power, more prospective clinical trials that directly compare these three methods are needed in the future.

Keywords: CT; Head and neck cancer; MRI; Mandibular invasion; PET-CT.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Head and Neck Neoplasms* / diagnostic imaging
  • Head and Neck Neoplasms* / pathology
  • Humans
  • Magnetic Resonance Imaging
  • Mandible* / diagnostic imaging
  • Mandible* / pathology
  • Neoplasm Invasiveness
  • Positron Emission Tomography Computed Tomography
  • Prospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed