Meta-analysis shows PET/CT alters management in one of five adults with abdominal malignancies

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Current oncology reports Published May 19, 2026 Medically reviewed May 19, 2026 Study authors: Brown Ethan, Patel Milin, Gupta Kartik, Farrell Ashley, Patlas Michael, Jajodia Ankush PubMed ↗ DOI ↗ By Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

Key Takeaway

Note that PET/CT alters management in roughly one of five patients with abdominal malignancies, but downstream benefits remain uncertain.

This systematic review and meta-analysis assessed the utility of 18-FDG PET/CT in adults with abdominal malignancies. The primary focus was on determining whether the imaging led to a change in management directly attributable to the findings. The analysis included fourteen studies, though only seven provided sufficient quantitative data for a formal meta-analysis. The authors observed that roughly 21.8% of patients underwent a management change, frequently driven by the identification of occult metastases that shifted treatment intent or surgical planning.

Beyond the immediate management changes, the review examined secondary outcomes such as survival, quality of life, and cost-effectiveness. The authors noted that evidence on these downstream outcomes was limited and heterogeneous across the included studies. Consequently, a quantitative synthesis for these specific outcomes was not possible, and the data did not support firm conclusions regarding long-term patient benefits or economic value.

Significant heterogeneity was present between the included studies, with substantial variation noted in the overall results. The authors caution that the magnitude of impact varies widely depending on the specific clinical context and tumor type. Therefore, while PET/CT clearly influences decision-making in a subset of patients, clinicians should interpret findings regarding long-term outcomes with restraint and avoid overgeneralizing the results to all abdominal malignancies.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

PMID42151646

View Original Abstract ↓

PURPOSE: To systematically review and assess the impact of 18 F-FDG PET/CT on multidisciplinary team (MDT) decision-making and management in adults with abdominal malignancies. MATERIALS & METHODS: We searched Ovid MEDLINE, Ovid Epub, Cochrane CENTRAL, EMBASE, and Scopus upto August 31, 2024, for studies including 18-FDG PET/CT and MDT management in abdominal malignancies in adult patients and describing pre- and post-PET/CT treatment plans or MDT decisions. Data extraction followed by independent two reviewer assessment using ROBINS-I framework. A random-effects meta-analysis of proportions was performed for studies reporting management change attributable to PET/CT. RESULTS: Fourteen studies met inclusion criteria, of which seven provided sufficient quantitative data for meta-analysis. A random-effects meta-analysis of the seven eligible quantitative studies showed that 21.8% of patients (95% CI: 10.6%-33.0%, p < 0.001; range: 8-36%) experienced a management change directly attributable to PET-based imaging. Between-study heterogeneity was substantial (I² ≈ 85%, p < 0.001). Reported management changes included cancellation or addition of planned surgery, modification of surgical extent, change in treatment intent between curative and palliative strategies, and alteration of systemic therapy or radiotherapy plans. Evidence on downstream outcomes such as survival, quality of life, and cost-effectiveness was limited and heterogeneous, precluding quantitative synthesis. CONCLUSION: PET/CT leads to a change in MDT management in roughly one in five patients with abdominal malignancies, often through re-staging and identification of occult metastases that alter treatment intent or surgical strategy. The magnitude of impact varies widely by clinical context and tumor type.