Diagnostic Accuracy of 18F-FDG-PET and PET/CT in the Differential Diagnosis between Malignant and Benign Pleural Lesions. A Systematic Review and Meta-Analysis.

Giorgio Treglia, Ramin Sadeghi, Salvatore Annunziata, Filippo Lococo, Stefano Cafarotti, Francesco Bertagna, John O. Prior, Luca Ceriani, Luca Giovanella

Research output: Contribution to journalArticlepeer-review

Abstract

Rationale and Objectives: To systematically review and meta-analyze published data about the diagnostic accuracy of fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and PET/computed tomography (CT) in the differential diagnosis between malignant and benign pleural lesions. Methods and Materials: A comprehensive literature search of studies published through June 2013 regarding the diagnostic performance of 18F-FDG-PET and PET/CT in the differential diagnosis of pleural lesions was carried out. All retrieved studies were reviewed and qualitatively analyzed. Pooled sensitivity, specificity, positive and negative likelihood ratio (LR+ and LR-) and diagnostic odds ratio (DOR) of 18F-FDG-PET or PET/CT in the differential diagnosis of pleural lesions on a per-patient-based analysis were calculated. Thearea under the summary receiver operating characteristic curve (AUC) was calculated to measure the accuracy of these methods. Subanalyses considering device used (PET or PET/CT) were performed. Results: Sixteen studies including 745 patients were included in the systematic review. The meta-analysis of 11 selected studies provided the following results: sensitivity 95% (95% confidence interval [95%CI]: 92-97%), specificity 82% (95%CI: 76-88%), LR+ 5.3 (95%CI: 2.4-11.8), LR- 0.09 (95%CI: 0.05-0.14), DOR 74 (95%CI: 34-161). The AUC was 0.95. No significant improvement of the diagnostic accuracy considering PET/CT studies only was found. Conclusions: 18F-FDG-PET and PET/CT demonstrated to be accurate diagnostic imaging methods in the differential diagnosis between malignant and benign pleural lesions; nevertheless, possible sources of false-negative and false-positive results should be kept in mind.

Original languageEnglish
Pages (from-to)11-20
Number of pages10
JournalAcademic Radiology
Volume21
Issue number1
DOIs
Publication statusPublished - Jan 2014

Keywords

  • Differential diagnosis
  • PET/CT
  • Pleura
  • Pleural lesions
  • Positron emission tomography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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