title: Comparison of the diagnostic performance of18F-fluorothymidine versus18F-fluorodeoxyglucose positron emission tomography on pulmonary lesions: A meta analysis.
abstract: A pulmonary lesion is an extremely common and clinically challenging disorder worldwide, and an accurate diagnosis of lung cancer is crucial for early treatment and management. The aim of the present study was to perform a comprehensive meta analysis to compare the diagnostic performance of18F-fluorothymidine (18F-FLT) positron emission tomography (PET) with18F-fluorodeoxyglucose (18F-FDG) PET in evaluating patients with pulmonary lesions. Relevant studies were identified using the PubMed, EMBASE and Cochrane library databases. The pooled estimated sensitivity, specificity, positive-likelihood ratio, negative-likelihood ratio, and diagnostic odds ratio (DOR) for18F-FLT PET versus18F-FDG PET were calculated as the main outcome measures. Summary receiver operating characteristic curves were also constructed by Meta-Disk 1.4 software using a Mose's constant of linear model. The meta analysis showed that18F-FLT PET had a higher specificity (0.70; 95% CI, 0.61-0.77), but lower sensitivity (0.81; 95% CI, 0.74-0.87) compared to18F-FDG PET (0.50; 95% CI, 0.41-0.58 for specificity; 0.92; 95% CI 0.86-0.95 for sensitivity). For DOR,18F-FLT PET (12.58; 95% CI, 6.81-23.24) was higher compared to18F-FDG PET (10.72; 95% CI, 5.51-20.87). The area under the curve was 0.8592 and 0.9240 for18F-FLT PET and18F-FDG PET, respectively (Z=0.976, P>0.05). In conclusion,18F-FLT PET and18F-FDG PET had good diagnostic performance for the overall assessment of pulmonary lesions, and18F-FLT PET had a higher specificity compared to18F-FDG PET, but was less sensitive than18F-FDG PET. Therefore,18F-FLT and18F-FDG together could add diagnostic confidence for pulmonary lesions.
authors.affiliation: Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China.
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Li
authors.affiliation: Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China.
authors.forename: Dong
authors.initials: D
authors.lastname: Dai
authors.affiliation: Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China.
authors.forename: Xiu-Yu
authors.initials: XY
authors.lastname: Song
authors.affiliation: Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China.
authors.forename: Jian-Jing
authors.initials: JJ
authors.lastname: Liu
authors.affiliation: Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China.
authors.forename: Yan-Jia
authors.initials: YJ
authors.lastname: Zhu
authors.affiliation: Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China.
authors.forename: Wen-Gui
authors.initials: WG
authors.lastname: Xu
keywords: 18F-fluorodeoxyglucose; 18F-fluorothymidine; meta analysis; positron emission tomography; pulmonary lesions