Abstract
Purpose Several meta-analyses have reported data about the diagnostic performance of positron emission tomography or positron emission tomography/computed tomography (PET or PET/CT) with different radiotracers in patients with suspicious lung cancer (LC) or pleural tumours (PT). This review article aims at providing an overview on the recent evidence-based data in this setting. Methods A comprehensive literature search of meta-analyses published in PubMed/MEDLINE and Cochrane Library database from January 2010 through March 2020 about the diagnostic performance of PET or PET/CT with different radiotracers in patients with suspicious LC or PT was performed. This combination of keywords was used: (A) “PET” OR “positron emission tomography” AND (B) “lung” OR “pulmonary” OR “pleur∗” AND (C) meta-analysis. Only meta-analyses on PET or PET/CT in patients with suspicious LC or PT were selected. Results We have summarized the diagnostic performance of PET or PET/CT with fluorine-18 fluorodeoxyglucose (18F-FDG) and other radiotracers taking into account 17 meta-analyses. Evidence-based data demonstrated a good diagnostic performance of 18F-FDG PET or PET/CT for the characterization of solitary pulmonary nodules (SPNs) or pleural lesions with overall higher sensitivity than specificity. Evidence-based data do not support the routine use of dual time point (DTP) 18F-FDG PET/CT or fluorine-18 fluorothymidine (18F-FLT) PET/CT in the differential diagnosis of SPNs. Even if 18F-FDG PET/CT has high sensitivity and specificity as a selective screening modality for LC, its role in this setting remains unknown. Conclusions Evidence-based data about the diagnostic performance of PET/CT with different radiotracers for suspicious LC or PT are increasing, with good diagnostic performance of 18F-FDG PET/CT. More prospective multicenter studies and cost-effectiveness analyses are warranted.
Highlights
Positron emission tomography (PET) is a noninvasive functional imaging method currently used for several oncological indications. is method can early detect pathophysiological changes in affected tissues in oncological patients, including patients with lung cancer (LC) or pleural tumours (PT), and these functional changes may occur before anatomical changes detected by conventional radiological techniques
(b) 18F-FDG PET or positron emission tomography/computed tomography (PET/CT) has good diagnostic performance for the characterization of solitary pulmonary nodules (SPNs) with higher sensitivity than specificity values. e use of 18F-FDG PET or PET/CT for the characterization of SPNs seems to be supported by evidence-based data in regions when the specificity of the method is not too low
(c) ere is a similar diagnostic performance among single time point (STP) and dual time point (DTP) 18F-FDG PET or PET/CT for the characterization of SPNs. e routine use of DTP 18F-FDG PET or PET/CT for this indication is currently not supported by evidence-based data
Summary
Positron emission tomography (PET) is a noninvasive functional imaging method currently used for several oncological indications. is method can early detect pathophysiological changes in affected tissues in oncological patients, including patients with lung cancer (LC) or pleural tumours (PT), and these functional changes may occur before anatomical changes detected by conventional radiological techniques. Positron emission tomography (PET) is a noninvasive functional imaging method currently used for several oncological indications. Contrast Media & Molecular Imaging as positron emission tomography/computed tomography (PET/CT) may provide combined functional and morphological information for early diagnosis of LC or PT [1]. Beyond 18F-FDG, other PET radiotracers evaluating different metabolic pathway or receptor status have been used and approved for oncological indications [2]. Meta-analysis is a statistical technique for combining the findings of independent studies included in a systematic review and it is often used to assess the diagnostic performance of imaging methods. All meta-analyses are systematic reviews with components of statistical pooling of data [3]. Several meta-analyses have been published about the diagnostic performance of PET or PET/CT with different radiotracers in oncology [3]
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