From the Department of Nuclear Medicine, Ewha Womans University College of Medicine, Seoul.
Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
Clin Nucl Med. 2021 Dec 1;46(12):983-988. doi: 10.1097/RLU.0000000000003880.
The incidence of lung cancer has increased steadily. We meta-analyzed to assess the impact of 18F-FDG PET on the management of lung cancer to detect recurrence/metastasis.
We performed systematic searches of Medline and Embase databases for English-language publications. All published studies regarding the impact of PET on the management of patients with lung cancer in detection of recurrence/metastasis were searched. The proportion of management change (%) defined as the percentage of patients who changed management after FDG PET to patients who had FDG PET was calculated. The data from each study were analyzed using MedCalc Statistical Software version 14.12.0 (MedCalc Software, Ostend, Belgium).
Eight studies including 523 patients were eligible for inclusion in the study. The impact of 18F-FDG PET for the purpose of detecting recurrence/metastasis in patients with lung cancer was evaluated using management change rates, which were ranged from 28.6% to 79.2% with a pooled effect of 61.4% (95% confidence interval, 49.5%-72.7%; I2 = 85.7%). In a subgroup analysis, impact of 18F-FDG PET was evaluated in studies of patients with non-small cell lung cancer with indication of abnormal findings of conventional imaging, elevated tumor markers, and clinical symptoms with the pooled rate of management change of 62.2% (95% confidence interval, 44.2%-78.5%; I2 = 88.0%).
We have highlighted that 18F-FDG PET has a major impact on the management of patients with recurrent lung cancer. These findings suggest that 18F-FDG PET should be performed in patients with lung cancer, especially in cases involving equivocal or suspicious recurrence/metastasis on conventional imaging, elevated tumor markers, or clinical symptoms during follow-up.
肺癌的发病率一直在稳步上升。我们进行了荟萃分析，以评估 18F-FDG PET 在肺癌管理中的作用，以检测复发/转移。
我们对 Medline 和 Embase 数据库进行了系统搜索，以查找英文出版物。搜索了所有关于 PET 对肺癌患者管理中复发/转移检测影响的研究。管理变更比例（%）定义为接受 FDG PET 后改变管理的患者比例，对每位患者进行计算。使用 MedCalc 统计软件版本 14.12.0（MedCalc Software，比利时奥斯坦德）对来自每项研究的数据进行分析。
纳入的 8 项研究共 523 例患者符合条件。使用管理变更率评估 18F-FDG PET 检测肺癌患者复发/转移的作用，其范围为 28.6%至 79.2%，汇总效应为 61.4%（95%置信区间，49.5%-72.7%；I2 = 85.7%）。在亚组分析中，根据常规影像学检查异常、肿瘤标志物升高和临床症状的指示，评估了 18F-FDG PET 在非小细胞肺癌患者中的作用，管理变更率的汇总率为 62.2%（95%置信区间，44.2%-78.5%；I2 = 88.0%）。
我们强调 18F-FDG PET 对复发性肺癌患者的管理有重大影响。这些发现表明，18F-FDG PET 应在肺癌患者中进行，特别是在常规影像学检查、肿瘤标志物升高或随访期间出现可疑复发/转移或临床症状的情况下。
