title: Diagnostic performance of integrated positron emission tomography/computed tomography for mediastinal lymph node staging in non-small cell lung cancer: a bivariate systematic review and meta-analysis.
abstract: BACKGROUND
  Accurate clinical staging of mediastinal lymph nodes (MLNs) of patients with non-small cell lung cancer (NSCLC) is important in determining therapeutic options and prognoses. Integrated positron emission tomography and computed tomography (PET/CT) scanning is becoming widely used for MLN staging in patients with NSCLC. We performed a bivariate meta-analysis to determine the pooled sensitivity (SEN) and specificity (SPE) of this imaging modality.
  
  
  METHODS
  The PubMed/MEDLINE, Embase, and SpringerLink databases were searched for articles related to PET/CT for MLN staging in patients with NSCLC. SEN and SPE were calculated for every study. Hierarchical summary receiver operating characteristic curves were used to summarize overall test performance and assess study quality. Potential between-study heterogeneity was explored by subgroup analyses.
  
  
  RESULTS
  Fourteen of 330 initially identified reports were included in the meta-analysis. When we did not consider the unit of analysis, the pooled weighted SEN and SPE were 0.73 (95% confidence interval [CI]: 0.65-0.79) and 0.92 (95% CI: 0.88-0.94), respectively. In the patient-based data analysis, the pooled weighted SEN was 0.76 (95% CI: 0.65-0.84) and the pooled weighted SPE was 0.88 (95% CI: 0.82-0.92). In the MLN-based data analysis, the pooled SEN was 0.68 (95% CI: 0.56-0.78) and the pooled SPE was 0.95 (95% CI: 0.91-0.97).
  
  
  CONCLUSIONS
  Integrated PET/CT is a relatively accurate noninvasive imaging technique, with excellent specificity for MLN staging in patients with NSCLC. Nevertheless, current evidence suggests that we should not depend on the results of PET/CT completely for MLN staging in patients with NSCLC.
authors.affiliation: Department of Respiratory Medicine, Jinling Hospital, School of Medicine, Southern Medical University (Guangzhou), Nanjing, China.
authors.forename: Yan-Ling
authors.initials: YL
authors.lastname: Lv
authors.forename: Dong-Mei
authors.initials: DM
authors.lastname: Yuan
authors.forename: Ke
authors.initials: K
authors.lastname: Wang
authors.forename: Xiao-Hui
authors.initials: XH
authors.lastname: Miao
authors.forename: Qian
authors.initials: Q
authors.lastname: Qian
authors.forename: Shu-Zhen
authors.initials: SZ
authors.lastname: Wei
authors.forename: Xi-Xu
authors.initials: XX
authors.lastname: Zhu
authors.forename: Yong
authors.initials: Y
authors.lastname: Song
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000473:pathology*; D015201:Meta-Analysis as Topic; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18