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CC BY 4.0 · World J Nucl Med
DOI: 10.1055/s-0045-1812491
Review Article

Diagnostic Performance of [18F]FDG PET/MRI and [18F]FDG PET/CT in the Detection of Lymph Node Metastases in Colorectal Cancer: A Meta-analysis

Autor*innen

  • Dapeng Shen

    1   The Second Clinical Medical College, Nanjing Medical University, Nanjing, People's Republic of China

  • Lexuan Chen

    1   The Second Clinical Medical College, Nanjing Medical University, Nanjing, People's Republic of China

  • Pengyuan Su

    1   The Second Clinical Medical College, Nanjing Medical University, Nanjing, People's Republic of China

  • Peng Chen

    1   The Second Clinical Medical College, Nanjing Medical University, Nanjing, People's Republic of China

  • Wei Zeng

    2   School of Pediatrics, Nanjing Medical University, Nanjing, People's Republic of China

  • Shen Chen

    3   School of Nursing, Nanjing Medical University, Nanjing, People's Republic of China

  • Jiemiao Shen

    3   School of Nursing, Nanjing Medical University, Nanjing, People's Republic of China

Funding This project was supported by the National Natural Science Foundation of China (no. 82202818), project of “Nursing Science” funded by the 4th Priority Discipline Development Program of Jiangsu Higher Education Institutions (Jiangsu Education Department (2023, no. 11), and Jiangsu Students Platform for innovation and entrepreneurship training program (no. 202310312074Y).
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Abstract

Background

Colorectal cancer (CRC) ranks among the leading causes of cancer-related mortality worldwide. Accurate detection of lymph node metastases plays a crucial role in determining disease stage and guiding treatment decisions. Fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) and 18F-FDG PET/magnetic resonance imaging (MRI) are advanced imaging modalities widely used in clinical practice. The study aimed to compare the diagnostic accuracy of [18F]FDG PET/CT and [18F]FDG PET/MRI in detecting lymph node metastases in CRC patients.

Methods

A comprehensive literature search was conducted across PubMed, Embase, and Web of Science databases to identify relevant studies published up to February 2025. Inclusion criteria encompassed studies evaluating the diagnostic performance of [18F]FDG PET/CT and [18F]FDG PET/MRI for detecting lymph node metastases in CRC patients. Sensitivity and specificity were analyzed using the DerSimonian and Laird random-effects model, with results adjusted by the Freeman-Tukey double arcsine transformation. The quality of the included studies was appraised using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.

Results

This meta-analysis incorporated 24 studies with a cumulative total of 3,369 patients. The findings revealed that [18F]FDG PET/CT exhibited significantly lower sensitivity (0.75 vs. 0.93, p = 0.0096) and a lower AUC value (0.81 vs. 0.96) compared with [18F]FDG PET/MRI in detecting lymph node metastases among CRC patients. Both [18F]FDG PET/CT and [18F]FDG PET/MRI demonstrated similar specificity (0.77 vs. 0.88, p = 0.1892). Furthermore, the funnel plot asymmetry test indicated no significant publication bias across any of the outcomes (Egger's test: all p > 0.05).

Conclusions

Our meta-analysis demonstrated that [18F]FDG PET/MRI has higher sensitivity and comparable specificity to [18F]FDG PET/CT in detecting lymph node metastases in CRC patients, suggesting its potential superiority for preoperative staging and postoperative surveillance. However, the limited number of direct head-to-head studies (only two) underscores the need for larger, prospective studies to validate these findings and assess their impact on clinical decision-making and patient outcomes.

Keywords

[18F]FDG PET/CT - [18F]FDG PET/MRI - colorectal cancer - lymph node metastases - meta-analysis

Reporting Checklist

The authors have completed the PRISMA reporting checklist, available at https://qims.amegroups.com.


Data Availability Statement

The original contributions presented in the study are included in the article/[Supplementary Material]; further inquiries can be directed to the corresponding author.


Authors' Contributions

Conception and design: D.S., L.C.

Administrative support: J.S., S.C.

Provision of study materials or patients: P.S., P.C., W.Z., S.C.

Collection and assembly of data: L.C., J.S.

Data analysis and interpretation: D.S., P.S., J.S.

Manuscript writing: All authors.

Final approval of manuscript: All authors.


Supplementary Material



Publikationsverlauf

Artikel online veröffentlicht:
12. November 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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