(18)F-FDG PET with or without CT in the diagnosis of extrahepatic metastases or local residual/recurrent hepatocellular carcinoma

The aim of the present study was to meta-analyze the literature on the diagnostic value of 18-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) with or without computed tomography (CT) in detecting extrahepatic metastases or local residual/recurrent hepatocellular carcinoma (HCC). Systematic review of literature in MEDLINE, Embase, and Cochrane databases was conducted in March 2017, and relevant studies analyzing the diagnostic performance of (18)F-FDG PET with or without CT were meta-analyzed. Meta-analysis was carried out on data from 11 studies involving 572 patients. (18)F-FDG PET, with or without CT, showed pooled sensitivity of 64% and pooled specificity of 95%. Pooled sensitivity was similar with CT (74%) or without (52%; P = .279). Similarly, pooled specificity was comparable with CT (93%) or without 95% (P = .481). (18)F-FDG PET, with or without CT, shows relatively low sensitivity but high specificity for diagnosing extrahepatic metastases or local residual/recurrent HCC. Adding CT to (18)F-FDG PET may improve diagnostic performance, but the available evidence suggests that the improvement is not statistically significant.