Long Hang, Hao Binwei, Cao Yuxi, Cai Yaoyao, Wei Shuang, Liu Xiansheng
Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China.
Department of Pulmonary and Critical Care Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, 030032, China.
Eur J Radiol. 2025 Feb;183:111916. doi: 10.1016/j.ejrad.2025.111916. Epub 2025 Jan 3.
This head-to-head comparative meta-analysis aimed to evaluate the comparative diagnostic efficacy of [F]FDG PET/CT and dynamic contrast-enhanced CT(DCE-CT) for the differentiation between malignant and benign pulmonary nodules.
An extensive search was conducted in the PubMed, Embase, and Web of Science to identify available publications up to March 23, 2024. Studies were included if they evaluated the diagnostic efficacy of [F]FDG PET/CT and DCE-CT for the characterization of pulmonary nodules. Sensitivity and specificity were assessed using the inverse variance method, followed by transformation via the Freeman-Tukey double inverse sine transformation. The quality of the included studies utilizing the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.
Seven articles involving 1,183 patients were included in the meta-analysis. The sensitivity of [F]FDG PET/CT was comparable to that of DCE-CT (0.88 vs. 0.87, P = 0.95). Similarly, the specificity of [F]FDG PET/CT was not significantly different from that of DCE-CT (0.63 vs. 0.54, P = 0.47). No significant publication bias was detected for any outcome (Egger's test: all P > 0.05). For DCE-CT, meta-regression analysis identified the mean lesion size of pulmonary nodules (<20 mm vs. ≥ 20 mm, P = 0.01) as a potential source of heterogeneity. Meanwhile, the number of patients (<100 vs. ≥ 100, P < 0.01) for PET/CT may also contribute to the heterogeneity.
Our meta-analysis indicates that [F]FDG PET/CT demonstrates similar sensitivity and specificity to DCE-CT for the diagnosis of pulmonary nodules. However, the number of the head-to-head studies were relatively small, further larger sample prospective research is required to confirm these findings.
本项头对头比较性荟萃分析旨在评估[F]FDG PET/CT与动态对比增强CT（DCE-CT）对肺结节良恶性鉴别的比较诊断效能。
在PubMed、Embase和Web of Science中进行广泛检索，以识别截至2024年3月23日的可用出版物。纳入评估[F]FDG PET/CT和DCE-CT对肺结节特征诊断效能的研究。采用逆方差法评估敏感性和特异性，随后通过弗里曼-图基双反正弦变换进行转换。使用诊断准确性研究质量评估（QUADAS-2）工具评估纳入研究的质量。
荟萃分析纳入了7篇涉及1183例患者的文章。[F]FDG PET/CT的敏感性与DCE-CT相当（0.88对0.87，P = 0.95）。同样，[F]FDG PET/CT的特异性与DCE-CT无显著差异（0.63对0.54，P = 0.47）。未检测到任何结局存在显著的发表偏倚（Egger检验：所有P>0.05）。对于DCE-CT，荟萃回归分析确定肺结节的平均病变大小（<20mm对≥20mm，P = 0.01）为异质性的潜在来源。同时，PET/CT的患者数量（<100对≥100，P<0.01）也可能导致异质性。
我们的荟萃分析表明，[F]FDG PET/CT在肺结节诊断中显示出与DCE-CT相似的敏感性和特异性。然而，头对头研究的数量相对较少，需要进一步开展更大样本的前瞻性研究来证实这些发现。
