Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100730, PR China.
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yongan Road, West District, Beijing 100050, PR China.
Eur J Radiol. 2021 Aug;141:109792. doi: 10.1016/j.ejrad.2021.109792. Epub 2021 May 26.
To investigate the predictive performance of the maximum standardized uptake value (SUV) and mean standardized uptake value (SUV) of primary lesions based on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) for EGFR mutation status in patients with non-small cell lung cancer (NSCLC).
The PubMed/Medline, Embase, Cochrane Library and Web of Science databases were searched as of January 1, 2021. Studies whose reported data could be used to construct contingency tables were included. Study characteristics were extracted, and methodological quality assessment was conducted by two separate reviewers using the Quality Assessment of Diagnostic Accuracy Studies. The pooled sensitivity, specificity and area under the summary receiver operating characteristic curve (AUROC) were calculated. The possible causes of heterogeneity were analysed by meta-regression.
The 18 included studies had a total of 4024 patients. The majority of the studies showed a low to unclear risk of bias and concerns of applicability. For differentiating EGFR-mutant NSCLC from wild-type NSCLC, the pooled sensitivity and specificity were 71 % and 60 % for SUV and 64 % and 63 % for SUV, respectively. The summary AUROCs of SUV and SUV were 0.69 (95 % CI, 0.65-0.73) and 0.68 (95 % CI, 0.64-0.72), respectively. The meta-regression analysis indicated that blindness to EGFR mutation test results, the number of readers and the number of PET/CT scanners were possible causes of heterogeneity.
Our meta-analysis implied that SUV and SUV of primary lesions from F-FDG PET/CT harboured moderate predictive efficacy for the EGFR mutation status of NSCLC.
探讨 18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）原发性病变最大标准化摄取值（SUV）和平均标准化摄取值（SUV）对非小细胞肺癌（NSCLC）患者表皮生长因子受体（EGFR）突变状态的预测性能。
检索 PubMed/Medline、Embase、Cochrane 图书馆和 Web of Science 数据库，检索时间截至 2021 年 1 月 1 日。纳入报告的数据可用于构建列联表的研究。由两名独立的评审员提取研究特征，并使用诊断准确性研究质量评估工具评估方法学质量。计算汇总受试者工作特征曲线下的敏感性、特异性和面积（AUROC）。采用 meta 回归分析异质性的可能原因。
18 项纳入研究共纳入 4024 例患者。大多数研究显示存在低到不清楚的偏倚风险和适用性问题。在区分 EGFR 突变型 NSCLC 与野生型 NSCLC 方面，SUV 和 SUV 的合并敏感性和特异性分别为 71%和 60%，64%和 63%。SUV 和 SUV 的汇总 AUROC 分别为 0.69（95%CI，0.65-0.73）和 0.68（95%CI，0.64-0.72）。meta 回归分析表明，EGFR 突变检测结果的盲法、阅片者数量和 PET/CT 扫描仪数量可能是异质性的原因。
我们的荟萃分析表明，18F-FDG PET/CT 原发性病变的 SUV 和 SUV 对 NSCLC 的 EGFR 突变状态具有中等预测效能。
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