The diagnosis performance of [18F]FDG PET/CT, MRI, and CT in the diagnosis of mandibular invasion in oral/oropharyngeal carcinoma: a head-to-head comparative meta-analysis

Purpose This research synthesis investigates the diagnostic performance of [ 18 F]FDG PET/CT, MRI, and CT in detecting mandibular invasion in patients with oral and oropharyngeal cancer. Methods An extensive literature review was conducted using PubMed and Embase, targeting studies up to March 2024 that examined the diagnostic capabilities of [ 18 F]FDG PET/CT, MRI, and CT for oral and oropharyngeal cancer patients. Sensitivity and specificity were calculated using the DerSimonian and Laird random-effects model with adjustments via the Freeman-Tukey double arc sine transformation. Study quality was assessed with the QUADAS-2 tool. Results This meta-analysis synthesized data from 24 studies involving 1376 participants to compare the diagnostic performance of CT, MRI, and [ 18 F]FDG PET/CT for mandibular invasion in oral and oropharyngeal cancer patients. The results showed closely matched sensitivity and specificity among the technologies: CT pooled a sensitivity of 0.80 and specificity of 0.85, while MRI exhibited a slightly better sensitivity at 0.87 but lower specificity at 0.81, with the differences not reaching statistical significance (all P > 0.05). [ 18 F]FDG PET/CT also demonstrated comparable performance, achieving a sensitivity of 0.77 versus CT’s 0.72 and a specificity of 0.82 versus CT’s 0.93, alongside matching MRI’s sensitivity at 0.86 and a specificity of 0.68 versus MRI’s 0.75, with all comparisons showing no significant disparities (all P > 0.05). Conclusions The meta-analysis concludes that there was no statistically significant difference in diagnostic performance between [ 18 F]FDG PET/CT, CT and MRI. Further research with prospective comparative trials is recommended to validate these findings in new clinical cohorts.