Login Register Cart 0
Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Meta-Analysis

Diagnostic Accuracy of F18-fluorodeoxyglucose Positron Emission Tomography- computed Tomography for the Detection of Non-small Cell Lung Cancer Recurrence: A Systematic Review and Meta-analysis

Author(s): Yunbing Chen, Deying Zhang and Ka Fan*

Volume 19, Issue 5, 2023

Published on: 27 August, 2022

Article ID: e020822207191 Pages: 10

DOI: 10.2174/1573405618666220802101446

Price: $65

Abstract

Background: The Non-Small Cell Variant of Lung Cancer (NSCLC) has a poorer prognosis. It is typically diagnosed through non-invasive imaging. Of particular note has been FDGPET/ CT, which has been investigated across various settings with differing results.

Objective: This study is to pool the available information on the diagnostic performance of 18-F FDG PET/CT for detecting NSCLC recurrence.

Methods: A systematic literature search was conducted across electronic databases for studies published before May 2021. The QUADAS tool was applied to assess study quality, and a metaanalysis was performed to retrieve pooled estimates. Chi-squared tests and I2 statistics were used to assess heterogeneity. Egger’s test and funnel plots were used to assess publication bias.

Results: The literature search yielded 20 studies featuring data on 1,973 patients. The majority of the studies had a low bias risk. The pooled sensitivity and specificity were 96% (95% CI: 91%- 98%) and 93% (95% CI: 89%-95%), respectively. The LRP and LRN estimates were in the left upper quadrant of the LR scattergram, indicating that F18-FDG PET/CT can be utilized for both confirmation and exclusion. The AUC was 0.98 (95% CI: 0.92-0.99). Fagan’s nomogram showed that F18-FDG PET/CT had good clinical utility for recurrent NSCLC diagnosis. There was considerable between-study variability (p=0.02). The funnel plot was asymmetrical, indicating the possibility of publication bias.

Conclusion: This meta-analysis found FDG-PET/CT to be highly accurate for identifying NSCLC recurrence. However, more studies assessing this modality across different patient situations are required to strengthen the argument for changing international guidelines and practices.

Keywords: 18F-FDG, non-small cell lung cancer, meta-analysis, PET/CT, validation studies, CT.

[1]
Molina JR, Yang P, Cassivi SD, Schild SE, Adjei AA. Non-small cell lung cancer: Epidemiology, risk factors, treatment, and survivor-ship. Mayo Clin Proc 2008; 83(5): 584-94.
[http://dx.doi.org/10.1016/S0025-6196(11)60735-0] [PMID: 18452692]
[2]
Johnson BE. Second lung cancers in patients after treatment for an initial lung cancer. J Natl Cancer Inst 1998; 90(18): 1335-45.
[http://dx.doi.org/10.1093/jnci/90.18.1335] [PMID: 9747865]
[3]
Henschke CI, Yankelevitz DF, Libby DM, Pasmantier MW, Smith JP, Miettinen OS. Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med 2006; 355(17): 1763-71.
[http://dx.doi.org/10.1056/NEJMoa060476] [PMID: 17065637]
[4]
Lung cancer screening: Recommendation statement. Ann Intern Med 2004; 140(9): 738-9.
[http://dx.doi.org/10.7326/0003-4819-140-9-200405040-00014] [PMID: 15126258]
[5]
Smith RA, von Eschenbach AC, Wender R, et al. American Cancer Society guidelines for the early detection of cancer: Update of early detection guidelines for prostate, colorectal, and endometrial cancers. Also: Update 2001--testing for early lung cancer detection. CA Cancer J Clin 2001; 51(1): 38-75.
[http://dx.doi.org/10.3322/canjclin.51.1.38] [PMID: 11577479]
[6]
Massaccesi M, Calcagni ML, Spitilli MG, et al. ¹⁸F-FDG PET-CT during chemo-radiotherapy in patients with non-small cell lung cancer: The early metabolic response correlates with the delivered radiation dose. Radiat Oncol 2012; 7: 106.
[http://dx.doi.org/10.1186/1748-717X-7-106] [PMID: 22781363]
[7]
Aerts HJWL, van Baardwijk AAW, Petit SF, et al. Identification of residual metabolic-active areas within individual NSCLC tumours using a pre-radiotherapy (18)Fluorodeoxyglucose-PET-CT scan. Radiother Oncol 2009; 91(3): 386-92.
[http://dx.doi.org/10.1016/j.radonc.2009.03.006] [PMID: 19329207]
[8]
Mankoff DA, Bellon JR. Positron-emission tomographic imaging of cancer: Glucose metabolism and beyond. Semin Radiat Oncol 2001; 11(1): 16-27.
[http://dx.doi.org/10.1053/srao.2001.18100] [PMID: 11146039]
[9]
Whiting PF, Rutjes AWS, Westwood ME, et al. QUADAS-2: A revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 2011; 155(8): 529-36.
[http://dx.doi.org/10.7326/0003-4819-155-8-201110180-00009] [PMID: 22007046]
[10]
Toba H, Sakiyama S, Otsuka H, et al. 18F-fluorodeoxyglucose positron emission tomography/computed tomography is useful in post-operative follow-up of asymptomatic non-small-cell lung cancer patients. Interact Cardiovasc Thorac Surg 2012; 15(5): 859-64.
[http://dx.doi.org/10.1093/icvts/ivs368] [PMID: 22914804]
[11]
Dane B, Grechushkin V, Plank A, Moore W, Bilfinger T. PET/CT vs. non-contrast CT alone for surveillance 1-year post lobectomy for stage I non-small-cell lung cancer. Am J Nucl Med Mol Imaging 2013; 3(5): 408-16.
[PMID: 24116349]
[12]
Bury T, Corhay JL, Duysinx B, et al. Value of FDG-PET in detecting residual or recurrent nonsmall cell lung cancer. Eur Respir J 1999; 14(6): 1376-80.
[http://dx.doi.org/10.1183/09031936.99.14613769] [PMID: 10624770]
[13]
Kanzaki R, Higashiyama M, Maeda J, et al. Clinical value of F18-fluorodeoxyglucose positron emission tomography-computed tomog-raphy in patients with non-small cell lung cancer after potentially curative surgery: Experience with 241 patients. Interact Cardiovasc Thorac Surg 2010; 10(6): 1009-14.
[http://dx.doi.org/10.1510/icvts.2009.227538] [PMID: 20197344]
[14]
Gambazzi F, Frey LD, Bruehlmeier M, et al. Comparing two imaging methods for follow-up of lung cancer treatment: A randomized pilot study. Ann Thorac Surg 2019; 107(2): 430-5.
[http://dx.doi.org/10.1016/j.athoracsur.2018.08.015] [PMID: 30292847]
[15]
Jiménez-Bonilla JF, Quirce R, Martínez-Rodríguez I, et al. Diagnosis of recurrence and assessment of post-recurrence survival in patients with extracranial non-small cell lung cancer evaluated by 18F-FDG PET/CT. Lung Cancer 2013; 81(1): 71-6.
[http://dx.doi.org/10.1016/j.lungcan.2013.03.015] [PMID: 23597930]
[16]
Hellwig D, Gröschel A, Graeter TP, et al. Diagnostic performance and prognostic impact of FDG-PET in suspected recurrence of surgically treated non-small cell lung cancer. Eur J Nucl Med Mol Imaging 2006; 33(1): 13-21.
[http://dx.doi.org/10.1007/s00259-005-1919-4] [PMID: 16151765]
[17]
Hicks RJ, Kalff V, MacManus MP, et al. The utility of (18)F-FDG PET for suspected recurrent non-small cell lung cancer after potentially curative therapy: Impact on management and prognostic stratification. J Nucl Med 2001; 42(11): 1605-13.
[PMID: 11696628]
[18]
Takenaka D, Ohno Y, Koyama H, et al. Integrated FDG-PET/CT vs. standard radiological examinations: Comparison of capability for assessment of postoperative recurrence in non-small cell lung cancer patients. Eur J Radiol 2010; 74(3): 458-64.
[http://dx.doi.org/10.1016/j.ejrad.2009.03.007] [PMID: 19398291]
[19]
Keidar Z, Haim N, Guralnik L, et al. PET/CT using 18F-FDG in suspected lung cancer recurrence: Diagnostic value and impact on patient management. J Nucl Med 2004; 45(10): 1640-6.
[PMID: 15471827]
[20]
Onishi Y, Ohno Y, Koyama H, et al. Non-small cell carcinoma: Comparison of postoperative intra- and extrathoracic recurrence assess-ment capability of qualitatively and/or quantitatively assessed FDG-PET/CT and standard radiological examinations. Eur J Radiol 2011; 79(3): 473-9.
[http://dx.doi.org/10.1016/j.ejrad.2010.04.027] [PMID: 20547021]
[21]
Opoka L. Szołkowska M, Podgajny Z, et al. Assessment of recurrence of non-small cell lung cancer after therapy using CT and Integrated PET/CT. Pneumonol Alergol Pol 2013; 81(3): 214-20.
[PMID: 23609428]
[22]
Zhang X, Liu H, Balter P, et al. Positron emission tomography for assessing local failure after stereotactic body radiotherapy for non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2012; 83(5): 1558-65.
[http://dx.doi.org/10.1016/j.ijrobp.2011.10.035] [PMID: 22572078]
[23]
Dissaux G, Visvikis D, Da-Ano R, et al. Pretreatment 18F-FDG PET/CT Radiomics Predict Local Recurrence in Patients Treated with Stereotactic Body Radiotherapy for Early-Stage Non-Small Cell Lung Cancer: A Multicentric Study. J Nucl Med 2020; 61(6): 814-20.
[http://dx.doi.org/10.2967/jnumed.119.228106] [PMID: 31732678]
[24]
Pastis NJ Jr, Greer TJ, Tanner NT, et al. Assessing the usefulness of 18F-fluorodeoxyglucose PET-CT scan after stereotactic body radio-therapy for early-stage non-small cell lung cancer. Chest 2014; 146(2): 406-11.
[http://dx.doi.org/10.1378/chest.13-2281] [PMID: 24577678]
[25]
Toba H, Kawakita N, Takashima M, et al. Diagnosis of recurrence and follow-up using FDG-PET/CT for postoperative non-small-cell lung cancer patients. Gen Thorac Cardiovasc Surg 2021; 69(2): 311-7.
[http://dx.doi.org/10.1007/s11748-020-01477-1] [PMID: 32909168]
[26]
Dong Y, Wu H, Wang Q, Li H, Zhou W, Tian Y, et al. Prediction of postoperative recurrence and metastasis with F18-FDG PET/CT in patients with non-small cell lung cancer. 2014.
[27]
Takeda A, Kunieda E, Fujii H, et al. Evaluation for local failure by 18F-FDG PET/CT in comparison with CT findings after stereotactic body radiotherapy (SBRT) for localized non-small-cell lung cancer. Lung Cancer 2013; 79(3): 248-53.
[http://dx.doi.org/10.1016/j.lungcan.2012.11.008] [PMID: 23246123]
[28]
Mu Y, Gui J, Lang Z, et al. Information feedback of 18F-FDG PET/CT computer imaging combined with tumor markers on recurrence and metastasis of non-small cell lung cancer. J Infect Public Health 2020; 13(9): 1336-41.
[http://dx.doi.org/10.1016/j.jiph.2019.06.027] [PMID: 31289004]
[29]
Tan D, Gill S, Loh N. Timing of fluorodeoxyglucose positron emission tomography maximum standardized uptake value for diagnosis of local recurrence of non-small cell lung cancer after stereotactic body radiation therapy. Cancer Med 2020; 9(20): 7469-76.
[http://dx.doi.org/10.1002/cam4.3302] [PMID: 32846054]
[30]
Walter SD. Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data. Stat Med 2002; 21(9): 1237-56.
[http://dx.doi.org/10.1002/sim.1099] [PMID: 12111876]
[31]
Jones CM, Athanasiou T. Summary receiver operating characteristic curve analysis techniques in the evaluation of diagnostic tests. Ann Thorac Surg 2005; 79(1): 16-20.
[http://dx.doi.org/10.1016/j.athoracsur.2004.09.040] [PMID: 15620907]
[32]
Li Q, Kim J, Balagurunathan Y, et al. CT imaging features associated with recurrence in non-small cell lung cancer patients after stereo-tactic body radiotherapy. Radiat Oncol 2017; 12(1): 158.
[http://dx.doi.org/10.1186/s13014-017-0892-y] [PMID: 28946909]
[33]
Caulo A, Mirsadraee S, Maggi F, Leccisotti L, van Beek EJR, Bonomo L. Integrated imaging of non-small cell lung cancer recurrence: CT and PET-CT findings, possible pitfalls and risk of recurrence criteria. Eur Radiol 2012; 22(3): 588-606.
[http://dx.doi.org/10.1007/s00330-011-2299-8] [PMID: 21969110]
[34]
Li J, Xu W, Kong F, Sun X, Zuo X. Meta-analysis: Accuracy of 18FDG PET-CT for distant metastasis staging in lung cancer patients. Surg Oncol 2013; 22(3): 151-5.
[http://dx.doi.org/10.1016/j.suronc.2013.04.001] [PMID: 23664848]
[35]
Basso Dias A, Zanon M, Altmayer S, et al. Fluorine 18–FDG PET/CT and diffusion-weighted MRI for malignant versus benign pulmo-nary lesions: A meta-analysis. Radiology 2019; 290(2): 525-34.
[http://dx.doi.org/10.1148/radiol.2018181159] [PMID: 30480492]
[36]
Liu J, Dong M, Sun X, Li W, Xing L, Yu J. Prognostic value of 18F-FDG PET/CT in surgical non-small cell lung cancer: A meta-analysis. PLoS One 2016; 11(1): e0146195.
[37]
Na F, Wang J, Li C, Deng L, Xue J, Lu Y. Primary tumor standardized uptake value measured on F18-Fluorodeoxyglucose positron emission tomography is of prediction value for survival and local control in non–small-cell lung cancer receiving radiotherapy: Meta-analysis. J Thorac Oncol 2014; 9(6): 834-42.
[PMID: 24787963]
[38]
Furuta M, Nozaki M, Kawashima M, et al. 99mTc-MIBI scintigraphy for early detection of locally recurrent non-small cell lung cancer treated with definitive radiation therapy. Eur J Nucl Med Mol Imaging 2003; 30(7): 982-7.
[http://dx.doi.org/10.1007/s00259-003-1188-z] [PMID: 12734691]
[39]
de Geus-Oei L-F, van der Heijden HFM, Corstens FHM, Oyen WJG. Predictive and prognostic value of FDG-PET in nonsmall-cell lung cancer: A systematic review. Cancer 2007; 110(8): 1654-64.
[http://dx.doi.org/10.1002/cncr.22979] [PMID: 17879371]
[40]
Saif MW, Tzannou I, Makrilia N, Syrigos K. Role and cost effectiveness of PET/CT in management of patients with cancer. Yale J Biol Med 2010; 83(2): 53-65.
[PMID: 20589185]
[41]
Kim CR, Kim B, Ning MS, et al. Cost analysis of PET/CT versus CT as surveillance for stage III non-small-cell lung cancer after defini-tive radiation therapy. Clin Lung Cancer 2018; 19(4): e517-28.
[http://dx.doi.org/10.1016/j.cllc.2018.03.012] [PMID: 29685701]
[42]
Scott WJ, Shepherd J, Gambhir SS. Cost-effectiveness of FDG-PET for staging non-small cell lung cancer: A decision analysis. Ann Thorac Surg 1998; 66(6): 1876-83.
[http://dx.doi.org/10.1016/S0003-4975(98)01055-8] [PMID: 9930463]
[43]
Zhang Y, Ni J, Wei K, Tian J, Sun S CT. MRI, and F-18 FDG PET for the detection of non-small-cell lung cancer (NSCLC): A protocol for a network meta-analysis of diagnostic test accuracy. Medicine (Baltimore) 2018; 97(38): e12387.
[http://dx.doi.org/10.1097/MD.0000000000012387] [PMID: 30235705]

Rights & Permissions Print Cite
Article Metrics
36
3
© 2024 Bentham Science Publishers | Privacy Policy