Impact of 18F-FDG PET/CT in Staging Patients With Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Francesco Martucci; Mariarosa Pascale; Maria Carla Valli; Gianfranco A Pesce; Patrizia Froesch; Luca Giovanella; Antonella Richetti; Giorgio Treglia

doi:10.3389/fmed.2019.00336

Impact of ¹⁸F-FDG PET/CT in Staging Patients With Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Front Med (Lausanne). 2020 Jan 29:6:336. doi: 10.3389/fmed.2019.00336. eCollection 2019.

Authors

Francesco Martucci¹, Mariarosa Pascale², Maria Carla Valli¹, Gianfranco A Pesce¹, Patrizia Froesch³, Luca Giovanella⁴, Antonella Richetti¹, Giorgio Treglia^{4

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Affiliations

¹ Clinic of Radiation Oncology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
² Clinical Trial Unit, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
³ Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
⁴ Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
⁵ Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁶ Health Technology Assessment Unit, Academic Education, Research and Innovation Area, General Directorate, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.

Abstract

Background: Molecular imaging methods are currently used in the management of patients with lung cancer. Compared to non-small cell lung cancer, less data are available about the impact of molecular imaging using fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in staging patients with small cell lung cancer (SCLC). Performing a systematic review and meta-analysis, we aimed to provide quantitative data about the impact of ¹⁸F-FDG PET/CT in staging SCLC. Methods: A comprehensive literature search of studies on the use of ¹⁸F-FDG PET/CT in patients with SCLC was performed. Three different databases were screened (PubMed/MEDLINE, EMBASE, and Cochrane library databases) until June 2019. Only articles describing the impact of ¹⁸F-FDG PET/CT in staging patients with SCLC were selected. A pooled analysis evaluating the change of binary SCLC staging (limited-stage vs. extensive-stage disease) using ¹⁸F-FDG PET/CT was carried out. Results: Nine articles including 721 patients with SCLC were included in the systematic review. Compared to conventional staging, a superior diagnostic accuracy of ¹⁸F-FDG PET/CT was found. A change of binary SCLC staging using ¹⁸F-FDG PET/CT was demonstrated in 15% (95% confidence interval, 9-21%) of patients with SCLC. Currently, it is not clearly demonstrated that the use of ¹⁸F-FDG PET/CT for staging may improve the survival outcome of patients with SCLC. Conclusions: ¹⁸F-FDG PET/CT is a useful molecular imaging method for staging patients with SCLC because it can change the management in a significant number of patients. More large prospective studies and cost-effectiveness analyses on the impact of ¹⁸F-FDG PET/CT in staging patients with SCLC are needed.

Keywords: lung cancer; molecular imaging; positron emission tomography/CT; small cell lung cancer; staging.

Publication types

Systematic Review