{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:33:55Z","timestamp":1792679635889,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Accurate staging is essential in anal cancer to guide therapy and prognostication. While MRI remains the modality of choice for local staging, its limitations in assessing nodal and distant metastases have prompted evaluation of\n                      <jats:styled-content style=\"fixed-case\">FDG PET<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\n                      as an adjunct. The American College of Radiology recommends FDG\u2010PET\/CT as a complementary modality for initial staging, particularly for nodal assessment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, EMBASE, Web of Science and Scopus was conducted up to August 2025 following PRISMA guidelines (PROSPERO ID: CRD1149778). Studies included reported adult patients with biopsy\u2010proven anal squamous cell carcinoma who underwent both MRI and FDG\u2010PET\/CT for initial staging. Primary outcomes included per\u2010patient sensitivity\/specificity for metastasis, changes in TNM staging and therapeutic outcomes, including management modification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009246) met the inclusion criteria. Five studies reported on staging changes, where FDG\u2010PET\/CT altered staging in 22.5% (95% CI: 12.3\u201334.7) of patients, more commonly through upstaging than downstaging (16.2% [95% CI: 10.7\u201322.5] vs. 6.3% [95% CI: 1.5\u201314.2]). Upstaged patients were predominantly nodal (74.6% [95% CI: 63.2\u201383.1]). Previously occult metastases were identified with FDG PET\/CT in 3% (95% CI: 1.1\u20136.9) of patients. Management changes occurred in 20.7% (95% CI: 14.9\u201327.4), predominantly through radiotherapy field expansion or dose modifications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FDG\u2010PET\/CT following MRI provides incremental diagnostic and therapeutic value in anal cancer staging, through refining nodal and metastatic staging and influencing radiotherapy planning, supporting its routine integration to optimise staging accuracy and management decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO: CRD42023446290<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1754-9485.70071","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T05:41:26Z","timestamp":1768887686000},"page":"188-197","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diagnostic and Therapeutic Impact of FDG\u2010PET\/CT Following MRI Staging in Anal Cancer: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9151-3431","authenticated-orcid":false,"given":"Hugo C.","family":"Temperley","sequence":"first","affiliation":[{"name":"Department of Radiology St James's Hospital  Dublin Ireland"},{"name":"Trinity College Dublin St James's Cancer Institute  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack M.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Radiology Beaumont Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3310-8259","authenticated-orcid":false,"given":"Avinash","family":"Deshwal","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons in Ireland (RCSI)  Dublin 2 Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanyang","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Surgery St John of God Subiaco Hospital  Subiaco Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom O.","family":"Cuddihy","sequence":"additional","affiliation":[{"name":"Department of Radiology St James's Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4534-2795","authenticated-orcid":false,"given":"Benjamin M.","family":"Mac Curtain","sequence":"additional","affiliation":[{"name":"Northwell Health  New Hyde Park NY USA"},{"name":"Department of Urology Lenox Hill Hospital  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall J.","family":"O'Sullivan","sequence":"additional","affiliation":[{"name":"Department of Radiology St James's Hospital  Dublin Ireland"},{"name":"Trinity College Dublin St James's Cancer Institute  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3525-8744","authenticated-orcid":false,"given":"Kevin P.","family":"Sheahan","sequence":"additional","affiliation":[{"name":"Department of Radiology St James's Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul H.","family":"McCormick","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery St James's Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Corr","sequence":"additional","affiliation":[{"name":"Department of Radiology St James's Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall","family":"Sheehy","sequence":"additional","affiliation":[{"name":"Department of Radiology St James's Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James F. M.","family":"Meaney","sequence":"additional","affiliation":[{"name":"Department of Radiology St James's Hospital  Dublin Ireland"},{"name":"The Thomas Mitchell Centre for Advanced Medical Imaging (CAMI), St. James' Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0757-6411","authenticated-orcid":false,"given":"Michael E.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Trinity College Dublin St James's Cancer Institute  Dublin Ireland"},{"name":"Department of Colorectal Surgery St James's Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2019.08.011"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.5493\/wjem.v14.i3.98525"},{"issue":"5","key":"e_1_2_14_4_1","doi-asserted-by":"crossref","first-page":"S396","DOI":"10.1016\/j.jacr.2025.02.018","article-title":"ACR Appropriateness Criteria(R) Staging and Follow\u2010Up of Anal Cancer","volume":"22","author":"Expert Panel on Gastrointestinal Imaging","year":"2025","journal-title":"Journal of the American College of Radiology"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-024-04213-y"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.655322"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9092715"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2014.07.030"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20170370"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-023-06393-z"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-022-08648-z"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604897"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2017.04.007"},{"key":"e_1_2_14_14_1","unstructured":"Innovation V.H \u201cCovidence Systematic Review Software\u201d(2024) www.covidence.org."},{"key":"e_1_2_14_15_1","unstructured":"G.Wells B.Shea D.O'Connell et\u00a0al. \u201cThe Newcastle\u2010Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta\u2010Analyses\u201d(2013) http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp."},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_14_17_1","unstructured":"Collaboration TC \u201cReview Manager (RevMan) Version 5.4\u201d(2020)."},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-13"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr599"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2010.02193.x"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2011.10.030"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.13.12256"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15112967"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.06.015"},{"key":"e_1_2_14_26_1","unstructured":"\u201c[Guideline] NCCN Clinical Practice Guidelines in Oncology: Anal Carcinoma. 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