Heterogeneity in Meta-analysis of FDG-PET Studies to Diagnose Lung Cancer

JAMA ◽  
2015 ◽  
Vol 313 (4) ◽  
pp. 419 ◽  
Author(s):  
Edward J. Mills ◽  
Jeroen P. Jansen ◽  
Steve Kanters
Keyword(s):  
Lung Cancer ◽  
Fdg Pet ◽  
Meta Analysis ◽  
Diagnose Lung Cancer

Heterogeneity in Meta-analysis of FDG-PET Studies to Diagnose Lung Cancer—Reply

JAMA ◽  
2015 ◽  
Vol 313 (4) ◽  
pp. 419
Author(s):  
Jeffrey D. Blume ◽  
Stephen A. Deppen ◽  
Eric L. Grogan
Keyword(s):  
Lung Cancer ◽  
Fdg Pet ◽  
Meta Analysis ◽  
Diagnose Lung Cancer

scholarly journals Multiple Testing, Cut-Point Optimization, and Signs of Publication Bias in Prognostic FDG–PET Imaging Studies of Head and Neck and Lung Cancer: A Review and Meta-Analysis

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1030
Author(s):  
Malene M. Clausen ◽  
Ivan R. Vogelius ◽  
Andreas Kjær ◽  
Søren M. Bentzen
Keyword(s):  
Lung Cancer ◽  
Head And Neck ◽  
Publication Bias ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Statistical Tests ◽  
Meta Analysis ◽  
Cut Points ◽  
Cut Point

Positron emission tomography (PET) imaging with 2-deoxy-2-[18F]-fluorodeoxyglucose (FDG) was proposed as prognostic marker in radiotherapy. Various uptake metrics and cut points were used, potentially leading to inflated effect estimates. Here, we performed a meta-analysis and systematic review of the prognostic value of pretreatment FDG–PET in head and neck squamous cell carcinoma (HNSCC) and non-small cell lung cancer (NSCLC), with tests for publication bias. Hazard ratio (HR) for overall survival (OS), disease free survival (DFS), and local control was extracted or derived from the 57 studies included. Test for publication bias was performed, and the number of statistical tests and cut-point optimizations were registered. Eggers regression related to correlation of SUVmax with OS/DFS yielded p = 0.08/p = 0.02 for HNSCC and p < 0.001/p = 0.014 for NSCLC. No outcomes showed significant correlation with SUVmax, when adjusting for publication bias effect, whereas all four showed a correlation in the conventional meta-analysis. The number of statistical tests and cut points were high with no indication of improvement over time. Our analysis showed significant evidence of publication bias leading to inflated estimates of the prognostic value of SUVmax. We suggest that improved management of these complexities, including predefined statistical analysis plans, are critical for a reliable assessment of FDG–PET.

scholarly journals Accuracy of FDG-PET to Diagnose Lung Cancer in a Region of Endemic Granulomatous Disease

2011 ◽  
Vol 92 (2) ◽  
pp. 428-433 ◽  
Author(s):  
Stephen Deppen ◽  
Joe B. Putnam ◽  
Gabriela Andrade ◽  
Theodore Speroff ◽  
Jonathan C. Nesbitt ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Fdg Pet ◽  
Granulomatous Disease ◽  
Diagnose Lung Cancer

scholarly journals Comparison of 18F-FDG PET/CT and DWI for detection of mediastinal nodal metastasis in non-small cell lung cancer: A meta-analysis

PLoS ONE ◽  
2017 ◽  
Vol 12 (3) ◽  
pp. e0173104 ◽  
Author(s):  
Guohua Shen ◽  
You Lan ◽  
Kan Zhang ◽  
Pengwei Ren ◽  
Zhiyun Jia
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Fdg Pet ◽  
Meta Analysis ◽  
Nodal Metastasis ◽  
Small Cell ◽  
Small Cell Lung ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Prognostic Value of MTV and TLG of 18F-FDG PET in Patients with Stage I and II Non-Small-Cell Lung Cancer: a Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Weibo Wen ◽  
Yongnan Piao ◽  
Dongyuan Xu ◽  
Xiangdan Li
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Fdg Pet ◽  
Meta Analysis ◽  
Small Cell ◽  
Stage I ◽  
Cochrane Library ◽  
Small Cell Lung ◽  
18F Fdg

Purpose. The present systematic literature review and meta-analysis focused on examining the significance of total lesion glycolysis (TLG) and metabolic tumor volume (MTV) in predicting the prognosis of stages I/II non-small-cell lung cancer (NSCLC) based on 18F-FDG PET parameters. Methods. Electronic databases, including Cochrane Library, PubMed, and EMBASE, were comprehensively searched for retrieving relevant articles published in the English language. Furthermore, the significance of TLG and MTV in prognosis prediction was analyzed by pooled hazard ratios (HRs). Results. This work enrolled eight primary studies with 1292 I/II-stage NSCLC cases. The pooled HR (95% confidence interval [CI]) for the ability of increased TLG to predict progression-free survival (PFS) was 2.02 (1.30–2.13) ( P = 0.350 ), while for increased MTV it was 3.04 (1.92–4.81) ( P = 0.793 ). In addition, the pooled HR (95% CI) for the ability of increased TLG to predict overall survival (OS) was 2.16 (1.49–3.14) ( P = 0.624 ). However, higher MTV correlated with OS, and sensitivity analysis showed that the results were not stable. Multivariate and univariate analyses by subgroup analyses stratified by PFS of MTV and OS of TLG exhibited statistically significant differences, without any statistical heterogeneity across various articles. Conclusion. The present work suggests the predictive value of PET/CT among stage I and II NSCLC patients. Our results verified that stage I/II NSCLC cases with increased TLG and MTV had a higher risk of side reactions, and TLG is related to increased mortality risk.

scholarly journals Prognostic Value of 18F-FDG PET/CT in Surgical Non-Small Cell Lung Cancer: A Meta-Analysis

PLoS ONE ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. e0146195 ◽  
Author(s):  
Jing Liu ◽  
Min Dong ◽  
Xiaorong Sun ◽  
Wenwu Li ◽  
Ligang Xing ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Small Cell ◽  
Small Cell Lung ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Can 18F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044313
Author(s):  
Bulin Du ◽  
Shu Wang ◽  
Yan Cui ◽  
Guanghui Liu ◽  
Xuena Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Fdg Pet ◽  
Meta Analysis ◽  
Small Cell ◽  
Scatter Plot ◽  
Small Cell Lung ◽  
Pet Ct ◽  
Fdg Pet Ct

ObjectivesThis study aimed to explore the diagnostic significance of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT for predicting the presence of epidermal growth factor receptor (EGFR) mutations in patients with non-small cell lung cancer (NSCLC).DesignA systematic review and meta-analysis.Data sourcesThe PubMed, EMBASE and Cochrane library databases were searched from the earliest available date to December 2020.Eligibility criteria for selecting studiesThe review included primary studies that compared the mean maximum of standard uptake value (SUVmax) between wild-type and mutant EGFR, and evaluated the diagnostic value of 18F-FDG PET/CT using SUVmax for prediction of EGFR status in patients with NSCLC.Data extraction and synthesisThe main analysis was to assess the sensitivity and specificity, the positive diagnostic likelihood ratio (DLR+) and DLR−, as well as the diagnostic OR (DOR) of SUVmax in prediction of EGFR mutations. Each data point of the summary receiver operator characteristic (SROC) graph was derived from a separate study. A random effects model was used for statistical analysis of the data, and then diagnostic performance for prediction was further assessed.ResultsAcross 15 studies (3574 patients), the pooled sensitivity for 18F-FDG PET/CT was 0.70 (95% CI 0.60 to 0.79) with a pooled specificity of 0.59 (95% CI 0.52 to 0.66). The overall DLR+ was 1.74 (95% CI 1.49 to 2.03) and DLR− was 0.50 (95% CI 0.38 to 0.65). The pooled DOR was 3.50 (95% CI 2.37 to 5.17). The area under the SROC curve was 0.68 (95% CI 0.64 to 0.72). The likelihood ratio scatter plot based on average sensitivity and specificity was in the lower right quadrant.ConclusionMeta-analysis results showed 18F-FDG PET/CT had low pooled sensitivity and specificity. The low DOR and the likelihood ratio scatter plot indicated that 18F-FDG PET/CT should be used with caution when predicting EGFR mutations in patients with NSCLC.

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