Diagnostic accuracy of imaging modalities in detection of histopathological extranodal extension: A systematic review and meta-analysis

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Abstract

Objective: To present an up to date systematic review and meta-analysis evaluating the diagnostic accuracy of the most used imaging modalities in detection of histopathological extra nodal extension (ENE) in head and neck squamous cell carcinoma. Materials and methods: Medline, Embase, and Cochrane databases were systematically searched on March 27th 2020. Screening, inclusion, quality assessment, and data extraction were done by two reviewers. Meta-analysis was conducted using the bivariate model approach after pooling the studies according to imaging modality. Heterogeneity was explored by meta-regression. Comparison was done by meta-regression and sub-group analyses. Results: Out of 476 initial hits, 25 studies were included for analysis. Of these, 14 dealt with CT, nine with PET/CT, four with MRI, two with ultrasound, and none with PET/MRI. Meta-analysis based on a total sample size of 3391 showed that CT had a sensitivity of 76% [67–82%] and specificity of 77% [69–83%], MRI a sensitivity of 72% [64–79%] and specificity of 78% [57–90%], and PET/CT a sensitivity of 80% [76–84%] and specificity of 83% [74–90%] in the ability to predict ENE. No meta-analysis could be done on ultrasound. There were no significant differences between modalities in overall accuracy; however, PET/CT had significantly higher sensitivity than CT and MRI. Conclusion: There was no significant difference in the ability of CT, MRI, and PET/CT to diagnose histopathological ENE, except that PET/CT had a significantly higher sensitivity than CT and MRI.

Original languageEnglish
Article number105169
JournalOral Oncology
Volume114
ISSN1368-8375
DOIs
Publication statusPublished - Mar 2021

Keywords

  • Extranodal extension
  • Head and neck cancer
  • Larynx
  • Magnetic resonance imaging
  • Oral cancer
  • Pharynx
  • Positron-emission tomography
  • Squamous cell carcinoma
  • Ultrasonography
  • X-ray computed tomography

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