title: Diagnostic value of computed tomography scanning in differentiating malignant from benign solitary pulmonary nodules: a meta-analysis.
abstract: An early diagnosis of lung cancer is crucial for early treatment and management. The objective of this systematic review was to assess the overall diagnostic accuracy of chest computed tomography (CT) scanning in differentiating malignant from benign solitary pulmonary nodules (SPNs) with meta-analysis. The PubMed and China National Knowledge Infrastructure (CNKI) database were searched for eligible studies published up to March 2014. The sensitivity, specificity, and other measures of accuracy of chest CT scanning in the diagnosis of SPNs were pooled along with 95 % confidence intervals (CI). Summary receiver operating characteristic (ROC) curves were used to summarize overall test performance. Thirty-two studies met our inclusion criteria. The summary estimates for chest CT scanning in the diagnosis of SPNs in the meta-analysis were as follows: pooled sensitivity, 0.89 (95 % CI, 0.88 to 0.91); pooled specificity, 0.70 (95 % CI, 0.68 to 0.73); positive likelihood ratio, 2.88 (95 % CI, 2.46 to 3.37); negative likelihood ratio, 0.16 (95 % CI, 0.12 to 0.21); and diagnostic odds ratio, 23.83 (95 % CI, 16.18 to 35.11). The results indicate that CT scanning has relatively high sensitivity and moderate specificity for the diagnosis of SPNs. Given the low cost and growing prevalence of the technology, CT scanning should be recommended as the initial test for the evaluation of SPNs.
authors.affiliation: Department of Radiology, Affiliated Hospital of Medical College, Qingdao University, Haier Road No. 59, Qingdao, 266101, Shandong, People's Republic of China.
authors.forename: Chuan-Yu
authors.initials: CY
authors.lastname: Zhang
authors.forename: Hua-Long
authors.initials: HL
authors.lastname: Yu
authors.forename: Xia
authors.initials: X
authors.lastname: Li
authors.forename: Yong-Ye
authors.initials: YY
authors.lastname: Sun
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000175:diagnosis*; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed / Q000379:methods*