Diagnostic value of fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography for the detection of metastases in non–small-cell lung cancer patients

Authors

  • Yihua Wu,

    1. Department of Medicine, Zhejiang University School of Public Health, Hangzhou 310009, People's Republic of China
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  • Peiwei Li,

    1. Department of Medicine, Zhejiang University School of Public Health, Hangzhou 310009, People's Republic of China
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    • Y.W. and P.L. contributed equally to this work

  • Honghe Zhang,

    1. Department of Medicine, Zhejiang University School of Public Health, Hangzhou 310009, People's Republic of China
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  • Yu Shi,

    1. Department of Medicine, Zhejiang University School of Public Health, Hangzhou 310009, People's Republic of China
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  • Han Wu,

    1. Department of Medicine, Zhejiang University School of Public Health, Hangzhou 310009, People's Republic of China
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  • Jinjie Zhang,

    1. Department of Medicine, Zhejiang University School of Public Health, Hangzhou 310009, People's Republic of China
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  • Yufeng Qian,

    1. Department of Medicine, Zhejiang University School of Public Health, Hangzhou 310009, People's Republic of China
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  • Chao Li,

    1. Department of Medicine, Zhejiang University School of Public Health, Hangzhou 310009, People's Republic of China
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  • Jun Yang

    Corresponding author
    1. Department of Medicine, Zhejiang University School of Public Health, Hangzhou 310009, People's Republic of China
    2. Department of Medicine, Hangzhou Normal University School of Public Health, Hangzhou 310009, People's Republic of China
    • State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, Qingchun Road Number 79, Hangzhou, People's Republic of China
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Abstract

In the recent years, fluorine 18 fluorodeoxyglucose (18F-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 18F-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 18F-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 18F-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. 18F-FDG PET/CT is beneficial in detecting lymph node metastases and extrathoracic metastases although PET/CT showed low sensitivity in detecting brain metastases. 18F-FDG PET/CT confers significantly higher sensitivity and specificity than contrast-enhanced CT (both p < 0.01) and higher sensitivity than 18F-FDG PET in staging NSCLC (p < 0.05).

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