Table 3.

Diagnostic performance of various imaging modalities in detecting nodal metastases.

					Sensitivity			Specificity
Anatomic Location	Analysis level	Modality	No. of studies	Publication Years	Summary estimate	95% CI*	I2 (%)	Summary estimate	95% CI*	I2 (%)	Cochran’s Q	P-value
All	Any	US	1	2015	N/A	0.43		N/A	0.96
		CT	8	2000–2019	0.51	0.36–0.67	81.5	0.87	0.81–0.92	74.8	15.264	<0.001
		MRI	37#	2000–2019	0.57	0.49–0.64	85.5	0.93	0.89–0.95	96.5	590.416	<0.001
		PET	42	2001–2019	0.57	0.48–0.65	80.3	0.95	0.93–0.97	91.0	198.715	<0.001
Pelvic	Patient	US	1	2015	N/A	0.43		N/A	0.96
		CT	3	2002–2019	N/A	0.15–0.79		N/A	0.63–0.97
		MRI	19	2001–2019	0.61	0.51–0.70	72.6	0.88	0.82–0.92	91.0	115.860	<0.001
		PET	18	2001–2019	0.60	0.48–0.70	73.8	0.93	0.87–0.96	82.9	70.132	<0.001
Pelvic	Site	CT (per side)	2	2000, 2017	N/A	0.51–0.65		N/A	0.86–0.97
		MRI	12	2000–2019	0.59	0.43–0.74	90.4	0.94	0.88–0.97	97.3	253.112	<0.001
		per side	3	2000–2017	N/A	0.24–0.71		N/A	0.80–0.96
		per region	3	2010–2012	N/A	0.25–0.83		N/A	0.93–0.98
		per node	6	2007–2019	0.66	0.44–0.82	93.8	0.92	0.80–0.97	98.4	213.770	<0.001
		PET	7	2005–2018	0.44	0.35–0.54	56.1	0.98	0.93–0.99	92.1	18.478	<0.001
		per side	4	2005–2018	0.38	0.24–0.54	53.6	0.95	0.88–0.98	70.5	5.818	0.027
		per region	2	2009, 2010	N/A	0.36–0.46		N/A	0.94–0.99
		Per node	1	2006	N/A	0.72		N/A	1.00
Paraaortic	Patient	CT	4	2002–2019	0.29	0.06–0.71	64.8	0.91	0.83–0.96	49.1	2.403	0.150
		MRI	4	2002–2018	0.40	0.17–0.68	60.1	0.91	0.79–0.97	76.9	8.431	0.007
		PET	15	2001–2019	0.59	0.37–0.77	78.8	0.96	0.92–0.98	83.5	26.834	<0.001
Paraaortic	Site	MRI (per region)	1	2010	N/A	0.25		N/A	0.94
		PET	2	2005, 2010	N/A	0.40–0.67		N/A	0.99–1.00
		per side	1	2005	N/A	0.40		N/A	0.99
		per region	1	2010	N/A	0.67		N/A	1.00
Pelvic or paraaortic	Patient	CT	3	2005–2017	N/A	0.31–0.76		N/A	0.62–0.88
		MRI	10	2001–2018	0.55	0.41–0.69	79.5	0.90	0.81–0.95	88.7	48.196	<0.001
		PET	15	2007–2017	0.69	0.53–0.81	81.3	0.90	0.84–0.94	83.1	49.770	<0.001
Pelvic or paraaortic	Site	MRI	8	2001–2014	0.39	0.29–0.50	92.6	0.96	0.94–0.98	99.1	213.842	<0.001
		per region	6	2001–2012	0.37	0.26–0.49	91.4	0.97	0.94–0.98	91.5	100.231	<0.001
		per node	2	2006, 2014	N/A	0.37–0.58		N/A	0.88–0.99
		PET	7	2001–2015	0.53	0.33–0.73	91.6	0.98	0.96–0.99	92.0	45.766	<0.001
		per region	6	2001–2015	0.44	0.30–0.58	77.5	0.98	0.96–0.99	93.0	30.214	<0.001
		per node	1	2014	N/A	0.91		N/A	0.98

CI = confidence interval; N/A = none available

^*ranges for endpoints with ≤3 included studies

^#1 of 38 studies (Kang S et al, 2013) assessing nodal metastasis using MRI was excluded due to instability of hierarchical modeling