Journal ArticleDOI
Accuracy of Positron Emission Tomography for Diagnosis of Pulmonary Nodules and Mass Lesions: A Meta-analysis
Michael K. Gould,Courtney C. Maclean,Courtney C. Maclean,Ware G. Kuschner,Chara E. Rydzak,Chara E. Rydzak,Douglas K Owens +6 more
TLDR
Positron emission tomography with 18-fluorodeoxyglucose is an accurate noninvasive imaging test for diagnosis of pulmonary nodules and larger mass lesions, although few data exist for nodules smaller than 1 cm in diameter.Abstract:
ContextFocal pulmonary lesions are commonly encountered in clinical practice,
and positron emission tomography (PET) with the glucose analog 18-fluorodeoxyglucose
(FDG) may be an accurate test for identifying malignant lesions.ObjectiveTo estimate the diagnostic accuracy of FDG-PET for malignant focal pulmonary
lesions.Data SourcesStudies published between January 1966 and September 2000 in the MEDLINE
and CANCERLIT databases; reference lists of identified studies; abstracts
from recent conference proceedings; and direct contact with investigators.Study SelectionStudies that examined FDG-PET or FDG with a modified gamma camera in
coincidence mode for diagnosis of focal pulmonary lesions; enrolled at least
10 participants with pulmonary nodules or masses, including at least 5 participants
with malignant lesions; and presented sufficient data to permit calculation
of sensitivity and specificity were included in the anaylsis.Data ExtractionTwo reviewers independently assessed study quality and abstracted data
regarding prevalence of malignancy and sensitivity and specificity of the
imaging test. Disagreements were resolved by discussion.Data SynthesisWe used a meta-analytic method to construct summary receiver operating
characteristic curves. Forty studies met inclusion criteria. Study methodological
quality was fair. Sample sizes were small and blinding was often incomplete.
For 1474 focal pulmonary lesions of any size, the maximum joint sensitivity
and specificity (the upper left point on the receiver operating characteristic
curve at which sensitivity and specificity are equal) of FDG-PET was 91.2%
(95% confidence interval, 89.1%-92.9%). In current practice, FDG-PET operates
at a point on the summary receiver operating characteristic curve that corresponds
approximately to a sensitivity and specificity of 96.8% and 77.8%, respectively.
There was no difference in diagnostic accuracy for pulmonary nodules compared
with lesions of any size (P = .43), for semiquantitative
methods of image interpretation compared with qualitative methods (P = .52), or for FDG-PET compared with FDG imaging with a modified
gamma camera in coincidence mode (P = .19).ConclusionsPositron emission tomography with 18-fluorodeoxyglucose is an accurate
noninvasive imaging test for diagnosis of pulmonary nodules and larger mass
lesions, although few data exist for nodules smaller than 1 cm in diameter.
In current practice, FDG-PET has high sensitivity and intermediate specificity
for malignancy.read more
Citations
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Journal ArticleDOI
Recommendations on the Use of 18F-FDG PET in Oncology
James W. Fletcher,James W. Fletcher,Benjamin Djulbegovic,Heloisa P. Soares,Barry A. Siegel,Val J. Lowe,Gary H. Lyman,R. Edward Coleman,Richard L. Wahl,John Christopher Paschold,Norbert Avril,Lawrence H. Einhorn,W. Warren Suh,David Samson,Dominique Delbeke,Mark Gorman,Anthony F. Shields +16 more
TL;DR: In this article, the authors developed recommendations on the use of 18F-FDG PET in breast, colorectal, esophageal, head and neck, lung, pancreatic and thyroid cancer; lymphoma, melanoma, and sarcoma; and unknown primary tumor.
Journal ArticleDOI
Clinical Applications of PET in Oncology
TL;DR: The physics and instrumentation aspects of PET, an analogue of glucose, are described and are being used in diagnosis and follow-up of several malignancies, and the list of articles supporting its use continues to grow.
Journal ArticleDOI
Test performance of positron emission tomography and computed tomography for mediastinal staging in patients with non-small-cell lung cancer: a meta-analysis.
Michael K. Gould,Ware G. Kuschner,Chara E. Rydzak,Courtney C. Maclean,Anita N Demas,Hidenobu Shigemitsu,Jo Kay Chan,Douglas K Owens +7 more
TL;DR: A synthesis of 39 studies found that FDG-PET was more accurate than CT for identifying lymph node involvement and CT was more sensitive but less specific in patients with lymph node enlargement on CT.
Journal ArticleDOI
The Solitary Pulmonary Nodule
TL;DR: A 60-year-old man undergoes chest radiography during an evaluation for pneumonia, and a 1.5-cm nodule is discovered, and he is a heavy smoker but has no history of lung disease.
Journal ArticleDOI
Progress and Promise of FDG-PET Imaging for Cancer Patient Management and Oncologic Drug Development
Gary J. Kelloff,John M. Hoffman,Bruce E. Johnson,Howard I. Scher,Barry A. Siegel,Edward Y. Cheng,Bruce D. Cheson,Joyce O'Shaughnessy,Kathryn Z. Guyton,David A. Mankoff,Lalitha K. Shankar,Steven M. Larson,Caroline C. Sigman,Richard L. Schilsky,Daniel C. Sullivan +14 more
TL;DR: Its potential to facilitate drug development in seven oncologic settings (lung, lymphoma, breast, prostate, sarcoma, colorectal, and ovary) is addressed and its potential as a surrogate of clinical benefit is addressed.
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