[Meta-analysis of the efficacy of positron emission tomography with F-18-fluorodeoxyglucose in lung tumors. Basis for discussion of the German Consensus Conference on PET in Oncology 2000].
BACKGROUND
: To analyse current literature on FDG-PET for evaluation of lung lesions, N-staging, M-staging, and recurrence of lung cancer for the third German Consensus Conference on PET in oncology.


METHODS
Specialists in nuclear medicine, pneumology, radiation oncology, diagnostic radiology, and thoracic surgery reviewed the relevant literature as listed in MEDLINE from 1985 to 1999 for further analysis. Out of the published data cumulative test parameters and summary receiver operating characteristic curves (sROC curves) were computed.


RESULTS
Sensitivity, specificity, and accuracy of FDG-PET are 96 %, 80 %, 91 % for evaluating lung lesions (15 studies with at least 35, in total 1144 patients). With corresponding values of 88 %, 92 %, 91 % (20 studies, 1292 patients) for N-staging FDG-PET is superior to CT with 65 %, 76 %, 73 % (19 studies, 1268 patients). With 94 %, 97 %, 96 % (4 studies, 336 patients) M-staging with FDG-PET is very accurate and changed therapeutic management in 18 % of the cases (8 studies, 695 patients), unexpected extrathoracic metastases were found in 12 % (7 studies, 581 patients). FDG-PET is the most accurate non-invasive method to evaluate suspected adrenal metastases (3 studies, 263 patients, sensitivity 96 %, specificity 99 %, accuracy 98 %). Recurrence is detected accurately (4 studies, 224 patients, sensitivity 99 %, specificity 89 %, accuracy 95 %).


CONCLUSIONS
Studies with in total more than 1000 patients show the high diagnostic efficacy of FDG-PET and its superiority to conventional imaging in lung cancer. Based on this analysis the third German Consensus Conference on PET in oncology evaluated FDG-PET on lung cancer. 1a-indications are evaluation of lung nodules in patients at risk for complications during surgery, N-staging, M-staging (except brain), and detection of recurrence.
Hellwig
D
D
Abteilung Nuklearmedizin der Radiologischen Universitätsklinik Homburg/Saar, Germany. Dirk.Hellwig@med-rz.uni-saarland.de
Ukena
D
D
Paulsen
F
F
Bamberg
M
M
Kirsch
C M
CM
D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D016239:MEDLINE; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
Metaanalyse zum Stellenwert der Positronen-Emissions-Tomographie mit F-18-Fluorodesoxyglukose (FDG-PET) bei Lungentumoren. Diskussionsbasis der deutschen Konsensus-Konferenz Onko-PET 2000 -