Uitgangsvraag: Bij patiënten met melanoom stadium III en IV (primair dan wel recidief) die in aanmerking komen voor in opzet curatieve/lokale behandeling, welke diagnostische test - FDG PET/CT, contrast CT of whole body MRI - resulteert in de meest accurate opsporing van metastasen? I Study ID II Method III Patient IV Intervention(s) V Results primary outcome VI Results secondary Critical appraisal of study characteristics and other outcomes quality et al, Prospective Eligibility criteria: Stage Index test(s) Diagnostic accuracy of evidence: B JEADV, 2014 cohort IV cutaneous melanoma MRI Lesion based of funding not patients including VIBE and Overall did not receive the mentioned Exclusion metabolic PET-CT same reference standard Hospital cancer, (diffusion) Accuracy: 86% regardless of the index size: 37 pat contraindications sequences 80% (71-87%) test result March for MRI combined PET-CT, 93% (86-97%) between index 2011 CT and superficial 93% (86-98%) test en reference test interval of 7 Patient characteristics lymph nodes US. 79% (70-87%) unclear days between Not reported unclear Reference standard CT of reference test of tests not visceral or lymph Accuracy: 81% unclear mentioned node metastases or sequential 90% (83-95%) imaging during 70% (60-79%) clinical follow-up (at 79% (71-85%) least 9 months) 85% (75-92%) MRI Accuracy: 70% 68% (59-76%) 73% (63-82%) 77% (68-85%) 63% (53-72%) MRI (VIBE) Accuracy: 85% 84% (76-90%) 87% (79-93%) 90% (83-95%) 80% (71-86%) Overall node PET-CT Accuracy: 96% 96% (78-100%) 97% (83-100%) 96% (78-100)
Uitgangsvraag: Bij patiënten met melanoom stadium III en IV (primair dan wel recidief) die in aanmerking komen voor in opzet curatieve/lokale behandeling, welke diagnostische test - FDG PET/CT, contrast CT of whole body MRI - resulteert in de meest accurate opsporing van metastasen? I Study ID II Method III Patient characteristics IV Intervention(s) V Results primary outcome VI Results secondary and other outcomes Critical appraisal of study quality et al, JEADV, 2014 Prospective cohort of funding not mentioned Hospital size: 37 pat March 2011 interval of 7 days between of tests not mentioned Eligibility criteria: Stage IV cutaneous melanoma patients Exclusion cancer, contraindications for MRI Patient characteristics Not reported visceral or lymph node metastases Index test(s) MRI including VIBE and metabolic (diffusion) sequences combined PET-CT, CT and superficial lymph nodes US. Reference standard or sequential imaging during clinical follow-up (at least 9 months) Diagnostic accuracy Lesion based Overall PET-CT Accuracy: 86% 80% (71-87%) 93% (86-97%) 93% (86-98%) 79% (70-87%) CT Accuracy: 81% 90% (83-95%) 70% (60-79%) 79% (71-85%) 85% (75-92%) MRI Accuracy: 70% 68% (59-76%) 73% (63-82%) 77% (68-85%) 63% (53-72%) MRI (VIBE) Accuracy: 85% 84% (76-90%) 87% (79-93%) 90% (83-95%) 80% (71-86%) Overall node PET-CT Accuracy: 96% 96% (78-100%) 97% (83-100%) 96% (78-100) of evidence: B did not receive the same reference standard regardless of the index test result between index test en reference test unclear unclear of reference test unclear
CoCanCPG_evidence_table_PICO_1_def.doc.docx