Diagnostic performance of Fluorine-18-Fluorodeoxyglucose positron emission tomography in the assessment of pleural abnormalities in cancer patients: A systematic review and a meta-analysis
A partir d'une revue systématique de la littérature publiée jusqu'en juin 2013 (8 études), cette méta-analyse évalue la performance d'une tomographie numérique par émission de positrons à base de fluorodésoxyglucose (18F) pour identifier des anomalies pleurales chez les patients atteints d'un cancer (360 cas dont 323 atteints d'un cancer du poumon)
Objective : To systematically review and meta-analyze published data about the diagnostic performance of Fluorine-18-Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and PET/computed tomography (PET/CT) in the assessment of pleural abnormalities in cancer patients.
Methods : A comprehensive literature search of studies published through June 2013 regarding the role of 18F-FDG-PET and PET/CT in evaluating pleural abnormalities in cancer patients was performed. All retrieved studies were reviewed and qualitatively analyzed. Pooled sensitivity, specificity, positive and negative likelihood ratio (LR+ and LR-) and diagnostic odd ratio (DOR) of 18F-FDG-PET or PET/CT on a per patient-based analysis were calculated. The area under the summary ROC curve (AUC) was calculated to measure the accuracy of these methods in the assessment of pleural abnormalities. Sub-analyses considering 18F-FDG-PET/CT and patients with lung cancer only were carried out.
Results : Eight studies comprising 360 cancer patients (323 with lung cancer) were included. The meta-analysis of these selected studies provided the following results: sensitivity 86% [95% confidence interval (95%CI): 80-91%], specificity 80% [95%CI: 73-85%], LR+ 3.7 [95%CI: 2.8-4.9], LR- 0.18 [95%CI: 0.09-0.34], DOR 27 [95%CI: 13-56]. The AUC was 0.907. No significant improvement considering PET/CT studies only and patients with lung cancer was found.
Conclusions : 18F-FDG-PET and PET/CT demonstrated to be useful diagnostic imaging methods in the assessment of pleural abnormalities in cancer patients, nevertheless possible sources of false-negative and false-positive results should be kept in mind. The literature focusing on the use of 18F-FDG-PET and PET/CT in this setting remains still limited and prospective studies are needed.
Lung Cancer , résumé, 2012