Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Apr;10(Suppl 7):S779-S789.
doi: 10.21037/jtd.2017.12.126.

Diagnostic performance of fluorine-18 fluorodeoxyglucose positron emission tomography in the management of solitary pulmonary nodule: a meta-analysis

Duilio Divisi  1 , Mirko Barone  1 , Luca Bertolaccini  2 , Gino Zaccagna  1 , Francesca Gabriele  1 , Roberto Crisci  1
Affiliations

Diagnostic performance of fluorine-18 fluorodeoxyglucose positron emission tomography in the management of solitary pulmonary nodule: a meta-analysis

Duilio Divisi et al. J Thorac Dis. 2018 Apr.

Abstract

Background: In the setting of solitary pulmonary nodules (SPNs), fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) is considered a useful non-invasive diagnostic tool though false positive (FP) and false negative (FN) results affects accuracy due to different conditions, such as inflammatory diseases or low-uptake neoplasms. Aim of this study is to evaluate overall diagnostic performance of 18F-FDG-PET/CT for malignant pulmonary nodules.

Methods: A computerized research, including published articles from 2012 and 2017, was carried out. 18F-FDG-PET/CT overall sensitivity (Se), specificity (Spe), positive likelihood ratio (PLR), negative likelihood ratio (NLR), positive predictive value (PPV), negative predictive value (NPV), diagnostic index and odds ratio were pooled. No selection-bias were found according to asymmetry test.

Results: A total of twelve studies were included in the meta-analysis. The pooled Se, Spe, PLR, NLR, PPV, NPV and accuracy index (AI) with relative 95% confidence intervals (CI) were 0.819 (95% CI: 0.794-0.843), 0.624 (95% CI: 0.582-0.665), 2.190 (95% CI: 1.950-2.440), 0.290 (95% CI: 0.250-0.330), 0.802 (95% CI: 0.783-0.819), 0.652 (95% CI: 0.618-0.684) and 0.649 (95% CI: 0.625-0.673), respectively. The diagnostic odds ratio (DOR) was 7.049 with a relative 95% CI between 5.550 and 8.944.

Conclusions: The results suggest 18F-FDG-PET/CT has good diagnostic accuracy in SPNs evaluation; but, it should not be considered as a discriminatory test rather than a method to be included in a clinical and diagnostic pathway.

Keywords: Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT); lung cancer; solitary pulmonary nodules (SPNs).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
QUADAS-2 quality assessment plot.
Figure 2
Figure 2
Flow chart of the selection process.
Figure 3
Figure 3
Forest plot according to 18F-FDG-PET/CT sensitivity (Se) for malignant solitary pulmonary nodules. 18F-FDG-PET/CT, fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography.
Figure 4
Figure 4
Forest plot according to 18F-FDG-PET/CT specificity (Spe) for malignant solitary pulmonary nodules. 18F-FDG-PET/CT, fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography.
Figure 5
Figure 5
Forest plot according to 18F-FDG-PET/CT accuracy index (AI) for malignant solitary pulmonary nodules. 18F-FDG-PET/CT, fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography.
Figure 6
Figure 6
Forest plot according to 18F-FDG-PET/CT odds ratio (OR) for malignant solitary pulmonary nodules. 18F-FDG-PET/CT, fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography.
Figure 7
Figure 7
Summarized ROC curve for 18F-FDG-PET/CT diagnostic performance in solitary pulmonary nodules management. 18F-FDG-PET/CT, fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography.
Figure 8
Figure 8
Asymmetry test (funnel plot) for publication bias.
See this image and copyright information in PMC

References

    1. Hansell DM, Bankier AA, MacMahon H, et al. Fleischner Society: glossary of terms for thoracic imaging. Radiology 2008;246:697-722. 10.1148/radiol.2462070712 - DOI - PubMed
    1. Gohagan J, Marcus P, Fagerstrom R, et al. Baseline findings of a randomized feasibility trial of lung cancer screening with spiral CT scan vs chest radiograph: the Lung Screening Study of the National Cancer Institute. Chest 2004;126:114-21. 10.1378/chest.126.1.114 - DOI - PubMed
    1. Coenen A, Honda O, van der Jagt EJ, et al. Computer-assisted solid lung nodule 3D volumetry on CT: influence of scan mode and iterative reconstruction: a CT phantom study. Jpn J Radiol 2013;31:677-84. 10.1007/s11604-013-0235-3 - DOI - PubMed
    1. Gould MK, Fletcher J, Iannettoni MD, et al. Evaluation of patients with pulmonary nodules: when is it lung cancer?: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007;132:108S-30S. - PubMed
    1. Henschke CI, Yankelevitz DF, Libby DM, et al. Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med 2006;355:1763-71. 10.1056/NEJMoa060476 - DOI - PubMed

LinkOut - more resources