title: The value of positron emission tomography in early detection of lung cancer in high-risk population: a systematic review.
abstract: BACKGROUND
  Early detection trials with chest radiography and sputum cytology were ineffective in decreasing lung cancer mortality. The advent of low-dose spiral chest computed tomography (LDCT) provided clinicians with a new tool that could be with early diagnosis; however, this also raised significant concerns regarding the systematic use of LDCT with its high false-positive rate for benign nodules. At this time, there is limited information about the true role of PET (positron emission tomography) for early detection of lung cancer.
  
  
  METHODS
  We used systematic methods, including Preferred Reporting Items for Systematic reviews and Meta-Analyses statement, to identify relevant studies, assess study eligibility, evaluate study methodological quality, and summarize findings regarding diagnostic accuracy and outcome.
  
  
  RESULTS
  In total, only seven eligible studies were selected from 82 potentially relevant studies. The sensitivity of 18F-FDG-PET for the detection of T1 lung cancers ranged between 68% and 95%. The rate of detection tended to be lower for carcinoid tumors, adenocarcinoma and bronchoalveolar cell carcinomas. FDG-PET using SUV (standardized uptake value) level can predict the outcome of the screening detected lung cancer. A combination of FDG-PET and LDCT may improve screening for lung cancer in high-risk patients.
  
  
  CONCLUSIONS
  PET or PET/CT may be used as a useful tool for early detection of lung cancer in high-risk population based on the existing information. However, there is still limited information with regards to evidence of survival benefits from PET screening in high-risk patients.
authors.affiliation: Division of Chest Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Cheng-Yu
authors.initials: CY
authors.lastname: Chang
authors.forename: Shu-Ju
authors.initials: SJ
authors.lastname: Chang
authors.forename: Shih-Chieh
authors.initials: SC
authors.lastname: Chang
authors.forename: Mei-Kang
authors.initials: MK
authors.lastname: Yuan
mesh_terms: D042241:Early Diagnosis; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods*; D049268:Positron-Emission Tomography; D012307:Risk Factors