Head-to-Head Comparison of [18F]FDG PET Imaging and MRI for the Detection of Recurrence or Residual Tumor in Patients with Nasopharyngeal Carcinoma: A Meta-Analysis

Background: This meta-analysis compared the diagnostic performance of [18F] fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) or PET versus Magnetic resonance imaging (MRI) in detecting recurrence or residual tumors at the primary site in patients with nasopharyngeal carcinoma (NPC). Methods: A comprehensive literature search was conducted in the PubMed/MEDLINE and CENTRAL databases to find studies with at least 20 patients with NPC undergoing both [18F]FDG PET/CT (or [18F]FDG PET) and MRI for detecting recurrence or assessing residual disease at the primary site. The pooled sensitivity and specificity of PET/CT and MRI were calculated with 95% confidence intervals (CIs) and compared. Results: Five studies, including 1908 patients (six patient groups), were included. PET imaging had higher sensitivity [93.3% (95% CI: 91.3–94.9%); I2 = 52.6%] compared to MRI [80.1% (95% CI: 77.2–82.8%); I2 = 68.3%], but the specificity of the two modalities was similar: 93.8% (95% CI: 92.2–95.2%; I2 = 0%) for PET/CT and 91.8% (95% CI: 90.1–93.4%; I2 = 94.3%) for MRI. The areas under the curve (AUCs) for PET/CT and MRI were 0.978 and 0.924, respectively, without significant difference (p = 0.23). Conclusions: This meta-analysis suggests that [18F]FDG PET imaging and MRI do not significantly differ in diagnostic performance. Nevertheless, [18F]FDG PET imaging shows higher sensitivity than MRI.