title: Performance of DWI in the Nodal Characterization and Assessment of Lung Cancer: A Meta-Analysis.
abstract: OBJECTIVE
  The purpose of this study is to assess the diagnostic performance of DWI in the N stage assessment of patients with lung cancer.
  
  
  METHODS
  The PubMed, EMBASE, Cochrane Library, Web of Science, and EBSCO English-language databases and two Chinese-language databases were searched for eligible studies. On the basis of the data extracted from included studies, we determined the pooled sensitivity and specificity, calculated the positive and negative likelihood ratios, and constructed summary ROC curves. In addition, we also performed threshold effect analysis, metaregression analysis, subgroup analysis, and publication bias analysis to explain the source of heterogeneity.
  
  
  RESULTS
  A total of 18 articles involving 1116 patients met the inclusion criteria. On a per-patient basis, the pooled sensitivity and specificity estimates of DWI were 0.68 (95% CI, 0.63-0.73) and 0.92 (95% CI, 0.90-0.94), respectively. On a per-lesion basis, the corresponding estimates were 0.72 (95% CI, 0.69-0.75) for sensitivity and 0.96 (95% CI, 0.95-0.96) for specificity. Only the analysis method (quantitative vs qualitative) affected the diagnostic accuracy on the basis of subgroup and metaregression analysis.
  
  
  CONCLUSIONS
  Current evidence suggests that DWI is beneficial in the nodal assessment of patients with lung cancer, and it is necessary to conduct high-quality prospective studies regarding the use of DWI in detecting metastatic lymph nodes of lung cancer to determine its true value.
authors.affiliation: 1 Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, People's Republic of China.
authors.forename: Guohua
authors.initials: G
authors.lastname: Shen
authors.affiliation: 1 Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, People's Republic of China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Hu
authors.affiliation: 1 Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, People's Republic of China.
authors.forename: Houfu
authors.initials: H
authors.lastname: Deng
authors.affiliation: 1 Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, People's Republic of China.
authors.forename: Anren
authors.initials: A
authors.lastname: Kuang
mesh_terms: D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging
keywords: DWI; N staging; lung cancer; meta-analysis