Update on nodal staging in non-small cell lung cancer with integrated positron emission tomography/computed tomography: a meta-analysis

Objectives Nowadays, the number of primary studies on fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has been increasing rapidly. Thus, we updated meta-analysis to evaluate the test performance of FDG PET/CT for nodal staging in non-small cell lung cancer (NSCLC)...

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Bibliographic Details
Published in:Annals of nuclear medicine 2015-06, Vol.29 (5), p.409-419
Main Authors: Pak, Kyoungjune, Park, Sohyun, Cheon, Gi Jeong, Kang, Keon Wook, Kim, In-Joo, Lee, Dong Soo, Kim, E. Edmund, Chung, June-Key
Format: Article
Language:English
Subjects:
Carcinoma, Non-Small-Cell Lung - diagnosis
Carcinoma, Non-Small-Cell Lung - diagnostic imaging
Carcinoma, Non-Small-Cell Lung - pathology
Humans
Imaging
Lymph Nodes - diagnostic imaging
Lymph Nodes - pathology
Lymphatic Metastasis
Medicine
Medicine & Public Health
Multimodal Imaging - instrumentation
Multimodal Imaging - methods
Mycobacterium
Neoplasm Staging
Nuclear Medicine
Original Article
Positron-Emission Tomography - instrumentation
Positron-Emission Tomography - methods
Radiology
Sensitivity and Specificity
Tomography, X-Ray Computed - instrumentation
Tomography, X-Ray Computed - methods
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Summary:Objectives Nowadays, the number of primary studies on fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has been increasing rapidly. Thus, we updated meta-analysis to evaluate the test performance of FDG PET/CT for nodal staging in non-small cell lung cancer (NSCLC) including the most recent studies. Methods We performed a systematic search of MEDLINE and EMBASE for English publications using keywords “positron emission tomography”, “lung cancer”, and “lymph node”. All searches were limited to human studies. Inclusion criteria were studies of the initial nodal staging of NSCLC with PET/CT. The reasons for exclusion are as follows: (1) studies with PET, (2) previous therapy before PET/CT, (3) nodal staging not confirmed by histology, and (4) reviews, abstracts, and editorial materials. 786 articles were identified through database searching. Results 28 studies including 3,255 patients and 11,887 lymph nodes (LN) were eligible for this study. The pooled sensitivity was 0.62 (95 % CI 0.54–0.70), widely ranging from 0.13 to 0.98. The specificity ranged between 0.72 and 0.98 with an overall estimated specificity of 0.92 (0.88–0.95) for node-based data. The pooled sensitivity, specificity, positive and negative likelihood ratio were 0.67 (0.54–0.79), 0.87 (0.82–0.91), 5.20 (3.59–7.54), and 0.37 (0.25–0.55) for patient-based data. Studies from tuberculosis (Tb) endemic countries showed lower sensitivity (0.56 vs 0.68, p  = 0.03) for node-based data and lower specificity (0.83 vs 0.89, p  
ISSN:0914-7187
1864-6433
DOI:10.1007/s12149-015-0958-6