Head-to-head comparison of 18 F-FDG PET/CT and 18 F-FDG PET/MRI for lymph node metastasis staging in non-small cell lung cancer: a meta-analysis.

Purpose: The current meta-analysis aimed to compare the diagnostic performance of ¹⁸ F-fluorodeoxyglucose positron emission tomography/computed tomography ( ¹⁸ F-FDG PET/CT) with ¹⁸ F-FDG PET/magnetic resonance imaging (MRI) in non-small cell lung cancer (NSCLC) lymph node metastasis staging.
Methods: We searched the PubMed, Web of Science, and Embase databases for relevant articles between November 1992 and September 2022. Studies evaluating the head-to-head comparison of ¹⁸ F-FDG PET/CT and ¹⁸ F-FDG PET/MRI for lymph node metastasis in patients with NSCLC were included. The quality of each study was assessed using the Quality Assessment of Diagnostic Performance Studies-2 tool.
Results: The analysis includes six studies with a total of 434 patients. The pooled sensitivity of ¹⁸ F-FDG PET/CT and ¹⁸ F-FDG PET/MRI was 0.78 [95% confidence interval (CI): 0.59-0.90] and 0.84 (95% CI: 0.68-0.93), and the pooled specificity was 0.87 (95% CI: 0.72-0.94) and 0.87 (95% CI: 0.80-0.92), respectively. The accuracy of ¹⁸ F-FDG PET/CT and ¹⁸ F-FDG PET/MRI was 0.81 (95% CI: 0.71-0.90) and 0.84 (95% CI: 0.75-0.92), respectively. When the pre-test probability was set at 50%, the post-test probability for ¹⁸ F-FDG PET/CT could increase to 85%, and the post-test probability for ¹⁸ F-FDG PET/MRI could increase to 87%.
Conclusion: ¹⁸ F-FDG PET/CT and ¹⁸ F-FDG PET/MRI have similar diagnostic performance in detecting lymph node metastasis in NSCLC. However, the results of this study were from a small sample study, and further studies with larger sample sizes are needed.