TY - JOUR
T1 - Metastases from non-small cell lung cancer
T2 - Mediastinal staging in the 1990s - Meta-analytic comparison of PET and CT
AU - Dwamena, Ben A.
AU - Sonnad, Seema S.
AU - Angobaldo, Jeff O.
AU - Wahl, Richard L.
PY - 1999/11
Y1 - 1999/11
N2 - PURPOSE: To meta-analytically compare 2-[fluorine 18]fluoro-2-deoxy-D- glucose positron emission tomography (PET) and computed tomography (CT) for the demonstration of mediastinal nodal metastases in patients with non-small cell lung cancer. MATERIALS AND METHODS: English-language reports on the diagnostic performance of PET (14 studies, 514 patients) and/or CT (29 studies, 2,226 patients) for demonstration of mediastinal nodal metastases from NSCLC were selected by using the MEDLINE database. In eligible studies, an objective diagnostic standard was used, data were presented to allow recalculation of contingency tables, and established diagnostic criteria were used for abnormal test results. Summary receiver operating characteristic (ROC) curves were calculated. RESULTS: Pooled point estimates of diagnostic performance and summary ROC curves indicated that PET was significantly more accurate than CT for demonstration of nodal metastases (P < .001). Mean sensitivity and specificity (± 95% CI) were 0.79 ± 0.03 and 0.91 ± 0.02, respectively, for PET and 0.60 ± 0.02 and 0.77 ± 0.02, respectively, for CT. The log odds ratios were 1.79 (95% CI: 1.49, 2.09) for CT and 3.77 (95% Cl: 2.77, 4.77) for PET (P < .001). Subgroup analyses did not alter findings. CONCLUSION: PET is superior to CT for mediastinal staging of non-small cell lung cancer, independent of performance index or clinical context of PET imaging.
AB - PURPOSE: To meta-analytically compare 2-[fluorine 18]fluoro-2-deoxy-D- glucose positron emission tomography (PET) and computed tomography (CT) for the demonstration of mediastinal nodal metastases in patients with non-small cell lung cancer. MATERIALS AND METHODS: English-language reports on the diagnostic performance of PET (14 studies, 514 patients) and/or CT (29 studies, 2,226 patients) for demonstration of mediastinal nodal metastases from NSCLC were selected by using the MEDLINE database. In eligible studies, an objective diagnostic standard was used, data were presented to allow recalculation of contingency tables, and established diagnostic criteria were used for abnormal test results. Summary receiver operating characteristic (ROC) curves were calculated. RESULTS: Pooled point estimates of diagnostic performance and summary ROC curves indicated that PET was significantly more accurate than CT for demonstration of nodal metastases (P < .001). Mean sensitivity and specificity (± 95% CI) were 0.79 ± 0.03 and 0.91 ± 0.02, respectively, for PET and 0.60 ± 0.02 and 0.77 ± 0.02, respectively, for CT. The log odds ratios were 1.79 (95% CI: 1.49, 2.09) for CT and 3.77 (95% Cl: 2.77, 4.77) for PET (P < .001). Subgroup analyses did not alter findings. CONCLUSION: PET is superior to CT for mediastinal staging of non-small cell lung cancer, independent of performance index or clinical context of PET imaging.
KW - Computed tomography (CT), comparative studies,
KW - Lung neoplasms, metastases
KW - Mediastinum, neoplasms
KW - Positron emission tomography (PET), comparative studies,
UR - http://www.scopus.com/inward/record.url?scp=0032712416&partnerID=8YFLogxK
U2 - 10.1148/radiology.213.2.r99nv46530
DO - 10.1148/radiology.213.2.r99nv46530
M3 - Article
C2 - 10551237
AN - SCOPUS:0032712416
VL - 213
SP - 530
EP - 536
JO - Radiology
JF - Radiology
SN - 0033-8419
IS - 2
ER -