title: 18F-FDG-PET evaluation of pathological tumour response to neoadjuvant therapy in patients with NSCLC.
abstract: OBJECTIVE
  The ability to identify potential responders to neoadjuvant treatment may improve patient selection or surgery and may help in the development of response criteria suitable for routine monitoring of response. The aim of this study was to evaluate the value of PET in predicting the pathological tumour response of non-small-cell lung cancer (NSCLC) to neoadjuvant therapy using a meta-analysis.
  
  
  METHODS
  All available published studies investigating the value of PET in predicting the pathological response of NSCLC to neoadjuvant therapy were collected. Pooled sensitivity and specificity data were obtained using statistical software. Subgroup analysis was performed to explore the sources of heterogeneity.
  
  
  RESULTS
  A total of 13 studies comprising 414 patients with NSCLC were included in the meta-analysis. Pooled sensitivity, specificity, positive predictive value and negative predictive value for PET-predicted response was 83% [95% confidence interval (CI); 76-89%], 84% (95% CI; 79-88%), 74% (95% CI; 67-81%) and 91% (95% CI; 87-94%), respectively. Significant heterogeneity (P<0.05) was observed. On the basis of our subgroup analyses, methodological quality could be responsible for this heterogeneity in our metaregression. The predictive value of PET in NSCLC patients with pathological response (considered the gold standard) was significantly higher than that of computed tomography (P<0.05).
  
  
  CONCLUSIONS
  PET scanning has an important role in predicting nonresponders to neoadjuvant therapy in cases of NSCLC, and the predictive value of PET for evaluating pathologically documented responses is superior to that of computed tomography. However, additional evaluations using prospective clinical trials will be required to assess the clinical benefit of this strategy.
authors.affiliation: Department of Nuclear Medicine, Shanghai Institute of Gastrointestinal Diseases, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Chenpeng
authors.initials: C
authors.lastname: Zhang
authors.forename: Jianjun
authors.initials: J
authors.lastname: Liu
authors.forename: Jinlu
authors.initials: J
authors.lastname: Tong
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Sun
authors.forename: Shaoli
authors.initials: S
authors.lastname: Song
authors.forename: Gang
authors.initials: G
authors.lastname: Huang
mesh_terms: D000818:Animals; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000628:therapy*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D064847:Multimodal Imaging / Q000379:methods*; D020360:Neoadjuvant Therapy / Q000379:methods*; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18