Diagnostic value of fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography for the detection of metastases in non-small-cell lung cancer patients.
In the recent years, fluorine 18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) has emerged as a new modality for staging non-small-cell lung cancer (NSCLC) patients. The aim of this meta-analysis was to assess the diagnostic value of (18)F-FDG PET/CT in detecting metastatic lesions in NSCLC patients. Meta-analysis methods were used to pool sensitivity, specificity, positive and negative likehood ratios, diagnostic odd ratios and to construct a summary receiver-operating characteristic curve. Data from included studies were pooled to compare the diagnostic accuracy between PET/CT and PET or CT alone in nodal staging. Totally, 56 studies involving 8,699 patients met the inclusion criteria. The pooled sensitivities and specificities of (18)F-FDG PET/CT were 0.72 [95% confidence interval (CI): 0.65-0.78] and 0.91 (95% CI: 0.86-0.94) in determining mediastinal nodal staging; 0.71 (95% CI: 0.60-0.80) and 0.83 (95% CI: 0.77-0.88) in intrathoracic staging; 0.78 (95% CI: 0.64-0.87) and 0.90 (95% CI: 0.84-0.94) in intrathoracic staging on a per-node basis. For detecting extrathoracic metastases, the pooled sensitivities and specificities of (18)F-FDG PET/CT were 0.77 (95% CI: 0.47-0.93) and 0.95 (95% CI: 0.92-0.97) for all extrathoracic metastases; 0.91 (95% CI: 0.80-0.97) and 0.98 (95% CI: 0.94-0.99) for bone metastases. (18)F-FDG PET/CT is beneficial in detecting lymph node metastases and extrathoracic metastases although PET/CT showed low sensitivity in detecting brain metastases. (18)F-FDG PET/CT confers significantly higher sensitivity and specificity than contrast-enhanced CT (both p < 0.01) and higher sensitivity than (18)F-FDG PET in staging NSCLC (p < 0.05).
Department of Medicine, Zhejiang University School of Public Health, Hangzhou 310009, People's Republic of China.
Yihua
Y
Wu
Peiwei
P
Li
Honghe
H
Zhang
Yu
Y
Shi
Han
H
Wu
Jinjie
J
Zhang
Yufeng
Y
Qian
Chao
C
Li
Jun
J
Yang
D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000556:secondary; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D012372:ROC Curve; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18