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Purpose <p>We conducted a systematic review and meta-analysis to assess and compare the diagnostic performance of elastosonography and 18&#xa0;F-FDG PET/CT in differentiating between benign and malignant salivary gland tumors.</p> Methods <p>Using PICOS criteria, experimental and observational research evaluating elastosonography or 18&#xa0;F-FDG PET/CT for differentiating benign and malignant salivary gland tumors were included. A systematic search was conducted across PubMed, Embase, Web of Science, Scopus, Cochrane Library, and CINAHL, initially in July 2024 and updated in February 2025. A manual search for relevant gray literature was also performed. Data extraction and risk of bias assessment using QUADAS-2 were conducted independently by reviewers.</p> Results <p>A total of 26 studies with 1609 patients were included in the analysis. The pooled sensitivity of elastosonography and 18&#xa0;F-FDG PET/CT in the differential diagnosis of benign and malignant salivary gland tumors were 0.75 (95% CI 0.65–0.84) and 0.84 (95% CI 0.78–0.90), specificity was 0.79 (95% CI 0.69–0.87) and 0.85 (95% CI 0.69–0.96), respectively. The area under the curve (AUC) for elastosonography and 18&#xa0;F-FDG PET/CT were 0.83 and 0.92 and there is a statistical difference between the two imaging modalities (Z = 2.77, <i>P</i> &lt; 0.01). Fagan nomogram indicated that when the pre-test probability was set at 20%, the post-test probability for elastosonography and 18&#xa0;F-FDG PET/CT could increase to 50% and 65%.</p> Conclusion <p>In differentiating between benign and malignant salivary gland tumors, 18&#xa0;F-FDG PET/CT exhibits a superior AUC compared to elastosonography, suggesting that, despite its current limited use in the initial workup of salivary gland tumors, there may be a strong argument for its increased adoption in clinical practice. Nevertheless, it is crucial to note that the findings of this meta-analysis rely on studies with limited sample sizes. More extensive prospective studies are warranted to validate these results further.</p>

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Comparative analysis of elastosonography and 18 F-FDG PET/CT in differentiating benign and malignant salivary gland tumors: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月1日

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  • Zhibing Jiang,
  • Jinjing Guo,
  • Liang Hu,
  • Xinran Zhao,
  • Siyu Yang,
  • Xiaokang Zhong,
  • Xiaoming Lei,
  • Qun Tang

摘要

Purpose

We conducted a systematic review and meta-analysis to assess and compare the diagnostic performance of elastosonography and 18 F-FDG PET/CT in differentiating between benign and malignant salivary gland tumors.

Methods

Using PICOS criteria, experimental and observational research evaluating elastosonography or 18 F-FDG PET/CT for differentiating benign and malignant salivary gland tumors were included. A systematic search was conducted across PubMed, Embase, Web of Science, Scopus, Cochrane Library, and CINAHL, initially in July 2024 and updated in February 2025. A manual search for relevant gray literature was also performed. Data extraction and risk of bias assessment using QUADAS-2 were conducted independently by reviewers.

Results

A total of 26 studies with 1609 patients were included in the analysis. The pooled sensitivity of elastosonography and 18 F-FDG PET/CT in the differential diagnosis of benign and malignant salivary gland tumors were 0.75 (95% CI 0.65–0.84) and 0.84 (95% CI 0.78–0.90), specificity was 0.79 (95% CI 0.69–0.87) and 0.85 (95% CI 0.69–0.96), respectively. The area under the curve (AUC) for elastosonography and 18 F-FDG PET/CT were 0.83 and 0.92 and there is a statistical difference between the two imaging modalities (Z = 2.77, P < 0.01). Fagan nomogram indicated that when the pre-test probability was set at 20%, the post-test probability for elastosonography and 18 F-FDG PET/CT could increase to 50% and 65%.

Conclusion

In differentiating between benign and malignant salivary gland tumors, 18 F-FDG PET/CT exhibits a superior AUC compared to elastosonography, suggesting that, despite its current limited use in the initial workup of salivary gland tumors, there may be a strong argument for its increased adoption in clinical practice. Nevertheless, it is crucial to note that the findings of this meta-analysis rely on studies with limited sample sizes. More extensive prospective studies are warranted to validate these results further.