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Can (18)F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis
OBJECTIVES: This study aimed to explore the diagnostic significance of (18)F-fluorodeoxyglucose ((18)F-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). DESIGN: A systematic...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8190055/ https://www.ncbi.nlm.nih.gov/pubmed/34103313 http://dx.doi.org/10.1136/bmjopen-2020-044313 |
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author | Du, Bulin Wang, Shu Cui, Yan Liu, Guanghui Li, Xuena Li, Yaming |
author_facet | Du, Bulin Wang, Shu Cui, Yan Liu, Guanghui Li, Xuena Li, Yaming |
author_sort | Du, Bulin |
collection | PubMed |
description | OBJECTIVES: This study aimed to explore the diagnostic significance of (18)F-fluorodeoxyglucose ((18)F-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). DESIGN: A systematic review and meta-analysis. DATA SOURCES: The PubMed, EMBASE and Cochrane library databases were searched from the earliest available date to December 2020. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: The review included primary studies that compared the mean maximum of standard uptake value (SUV(max)) between wild-type and mutant EGFR, and evaluated the diagnostic value of (18)F-FDG PET/CT using SUV(max) for prediction of EGFR status in patients with NSCLC. DATA EXTRACTION AND SYNTHESIS: The 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 SUV(max) 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. RESULTS: Across 15 studies (3574 patients), the pooled sensitivity for (18)F-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. CONCLUSION: Meta-analysis results showed (18)F-FDG PET/CT had low pooled sensitivity and specificity. The low DOR and the likelihood ratio scatter plot indicated that (18)F-FDG PET/CT should be used with caution when predicting EGFR mutations in patients with NSCLC. |
format | Online Article Text |
id | pubmed-8190055 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-81900552021-06-25 Can (18)F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis Du, Bulin Wang, Shu Cui, Yan Liu, Guanghui Li, Xuena Li, Yaming BMJ Open Diagnostics OBJECTIVES: This study aimed to explore the diagnostic significance of (18)F-fluorodeoxyglucose ((18)F-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). DESIGN: A systematic review and meta-analysis. DATA SOURCES: The PubMed, EMBASE and Cochrane library databases were searched from the earliest available date to December 2020. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: The review included primary studies that compared the mean maximum of standard uptake value (SUV(max)) between wild-type and mutant EGFR, and evaluated the diagnostic value of (18)F-FDG PET/CT using SUV(max) for prediction of EGFR status in patients with NSCLC. DATA EXTRACTION AND SYNTHESIS: The 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 SUV(max) 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. RESULTS: Across 15 studies (3574 patients), the pooled sensitivity for (18)F-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. CONCLUSION: Meta-analysis results showed (18)F-FDG PET/CT had low pooled sensitivity and specificity. The low DOR and the likelihood ratio scatter plot indicated that (18)F-FDG PET/CT should be used with caution when predicting EGFR mutations in patients with NSCLC. BMJ Publishing Group 2021-06-08 /pmc/articles/PMC8190055/ /pubmed/34103313 http://dx.doi.org/10.1136/bmjopen-2020-044313 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Diagnostics Du, Bulin Wang, Shu Cui, Yan Liu, Guanghui Li, Xuena Li, Yaming Can (18)F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis |
title | Can (18)F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis |
title_full | Can (18)F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis |
title_fullStr | Can (18)F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis |
title_full_unstemmed | Can (18)F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis |
title_short | Can (18)F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis |
title_sort | can (18)f-fdg pet/ct predict egfr status in patients with non-small cell lung cancer? a systematic review and meta-analysis |
topic | Diagnostics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8190055/ https://www.ncbi.nlm.nih.gov/pubmed/34103313 http://dx.doi.org/10.1136/bmjopen-2020-044313 |
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