Original InvestigationDiagnostic Accuracy of 18F-FDG-PET and PET/CT in the Differential Diagnosis between Malignant and Benign Pleural Lesions: A Systematic Review and Meta-Analysis
Section snippets
Methods
This systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement that describes an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses (8).
Literature Search
The comprehensive computer literature search from PubMed/MEDLINE and Scopus databases revealed 540 articles. Reviewing titles and abstracts, 524 articles were excluded: 464 because they were not in the field of interest of this review, 8 because they were evaluating the diagnostic performance of 18F-FDG-PET or PET/CT in assessing pleural lesions in patients with history of cancer 13, 14, 15, 16, 17, 18, 19, 20, 35 because they were reviews or editorials, 15 because they case reports, and 2
Discussion
To the best of our knowledge, this systematic review and meta-analysis is the first to evaluate the diagnostic accuracy of 18F-FDG-PET or PET/CT in the differential diagnosis between malignant and benign pleural lesions. Several studies have used 18F-FDG-PET or PET/CT in this setting, reporting different values of sensitivity and specificity (Table 3). However, many of these studies have limited power, analyzing only relatively small numbers of patients. To derive more robust estimates of the
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.
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2021, Lung CancerCitation Excerpt :In subgroup analysis, the authors found no change in the diagnostic value of PET/PET-CT in patients with known malignancy, which is in contrast to parts of our results, probably due to considerable and unadjusted heterogeneity. Treglia et al concluded that FDG PET/PET-CT is an accurate diagnostic imaging method in the differential diagnosis between malignant and non-malignant pleural lesions including effusions [24]. The review included sixteen studies with 745 patients.
Updates in Pleural Imaging
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2019, Revue des Maladies RespiratoiresEarly Contrast Enhancement: A novel magnetic resonance imaging biomarker of pleural malignancy
2018, Lung CancerCitation Excerpt :Recent meta-analyses have demonstrated a pooled sensitivity of 81% and specificity 74% for detecting PM, with considerable variation between studies [11]. Tumours with low metabolic activity, such as early stage epithelioid MPM are more likely to have a false negative PET-CT and false positives in patients with inflammatory pleuritis, TB pleuritis and previous pleurodesis are well recognised [12–14]. Efficient diagnosis is further complicated by the variable performance of pleural cytology, which has a mean sensitivity of 60% (depending on tumour type) but extremely low negative predictive value (NPV) in MPM, for which histological confirmation remains mandatory in most centres.