| Summary: | Objective To assess the diagnostic value of whole body 18F-fludeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT imaging) in cancer of unknown primary (CUP) and provide references for the detecting strategy of patients with unknown primary metastases. Methods The studies concerning diagnostic value of whole body 18F-FDG PET/CT imaging in the search for primary lesions of CUP were retrieved and screened from the published English and Chinese literatures from January 2010 to March 2019. After data extraction and quality evaluation, the calculation of summary receiver operating pooled sensitivity, specificity and 95%CI, and demonstrated the plots based on the calculation. Summary receiver operating characteristic (SROC) and a funnel graph were drawn. Finally, heterogeneity of the included studies was tested and exploration of the source of the heterogeneity was also included if necessary. Results Eighteen studies were finally included. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio and the corresponding 95%CI, for diagnosis of CUP were 0.88 (95%CI: 0.81~0.92), 0.76 (95%CI: 0.65~0.84), 3.61 (95%CI: 2.4~5.4), 0.16 (95%CI: 0.10~0.27), and 22 (95%CI: 11~46), respectively. The area under the SROC curve (AUC) was 0.89 (95%CI: 0.86~0.92). Conclusion 18F-FDG PET/CT shows sound diagnostic efficiency in detection of primary lesion site in patients with CUP, and is worthy of extensive application and promotion in clinical practice. It is worth noting that future studies should clear the definition of CUP.
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