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Head-to-head comparison of [18F]FDG PET/MRI and [18F] FDG PET/CT for TNM staging in non-small cell lung cancer: a systematic review and meta-analysis

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Abstract

Purpose

This study aimed to compare the diagnostic accuracy of [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/ magnetic resonance imaging (MRI) and [18F]FDG PET/ computed tomography (CT) in tumor–node–metastasis staging of non-small-cell lung cancer.

Methods

The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Diagnostic Test Accuracy (PRISMA-DTA) guidelines and retrieved all accessible studies from the Embase, PubMed, and Web of Science databases up to December 2022. Only studies in which both [18F]FDG PET/MRI and [18F]FDG PET/CT were conducted on each individual patient were included. Two researchers independently extracted data on study characteristics and assessed the methodological quality using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.

Results

A total of 539 patients in eight studies were included in this analysis. For T staging, the pooled sensitivity of [18F]FDG PET/CT was 0.90 (95% confidence interval [CI]: 0.81–0.96) and specificity of 0.97 (95% CI: 0.89–1.00), with corresponding values for [18F]FDG PET/MRI of 0.88 (95% CI: 0.78–0.94) and 0.95 (95% CI: 0.87–0.99), respectively. For N staging, the pooled sensitivity of [18F] FDG PET/CT was 0.70 (95% CI: 0.63–0.76), the specificity of 0.92 (95% CI: 0.88–0.95), and the area under the curve (AUC) was 0.90 (standard error [SE] = 0.06). The corresponding values for [18F]FDG PET/MRI were 0.71 (95% CI: 0.65–0.77), 0.91 (95% CI: 0.87–0.94) and 0.88 (SE = 0.06), respectively. For M staging, the pooled sensitivity was 0.79 (95% CI: 0.62–0.91), the specificity was 0.94 (95% CI: 0.90–0.97), and AUC was 0.96 (SE = 0.03) for [18F]FDG PET/CT. The corresponding values were 0.82 (95% CI: 0.70–0.91), 0.96 (95% CI: 0.93–0.98), and 0.94 (SE = 0.03), respectively, for [18F]FDG PET/MRI.

Conclusions

According to the pooled data, [18F]FDG PET/CT performed slightly better in terms of T staging than [18F]FDG PET/MRI. In contrast, with regard to N staging and M staging the staging accuracy of both imaging techniques was comparable. To ensure that results are reliable, more high-level investigations will be required to assess these imaging modalities, in addition to optimized PET/MRI procedures.

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Data availability

The study’s original contributions are described in the paper. If you have more questions, you can contact the writers.

Abbreviations

[18F]FDG PET/CT:

18F-Fluorodeoxyglucose positron emission tomography/computed tomography

[18F]FDG PET/MRI:

18F-Fluorodeoxyglucose positron emission tomography/magnetic resonance imaging

NSCLC:

Non–small cell lung cancer

PRISMA-DTA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Diagnostic Test Accuracy

QUADAS-2:

Quality Assessment of Diagnostic Accuracy Studies-2

AUC:

Area Under Curve

SE:

Standard error

Src:

Spearman rank correlation coefficient

TN:

True positive

FP:

False positive

FN:

False negative

TN:

True negative

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Authors and Affiliations

  1. Graduate School of Dalian Medical University, Dalian Medical University, Dalian, 116044, China

    Zhiwei Li, Dianhan Sun, Anying Li & Yusheng Shu

  2. Department of Thoracic Surgery, Subei People’s Hospital of Jiangsu Province, Yangzhou, 225001, China

    Zhiwei Li, Dianhan Sun, Anying Li & Yusheng Shu

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ZL and DS designed and AL proofed the work. Data was gathered and analyzed by DS and AL. The text was by ZL. The article was written by all authors and accepted.

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Correspondence to Yusheng Shu.

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Li, Z., Sun, D., Li, A. et al. Head-to-head comparison of [18F]FDG PET/MRI and [18F] FDG PET/CT for TNM staging in non-small cell lung cancer: a systematic review and meta-analysis. Clin Transl Imaging (2024). https://doi.org/10.1007/s40336-024-00622-7

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