Meta-analysis of PET/CT metabolic parameters for predicting NSCLC response after neoadjuvant therapy
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Key Takeaway
Consider the high diagnostic accuracy of PET/CT metabolic parameters for predicting NSCLC response after neoadjuvant therapy.
This is a meta-analysis of studies evaluating 18F-FDG PET/CT metabolic parameters to predict major pathological response after neoadjuvant therapy in patients with non-small cell lung cancer. The analysis pooled data from 1,315 subjects.
The authors synthesized findings on two metabolic parameters. For ΔSUVmax%, the summary sAUC was 0.96 (95% CI: 0.94-0.97), with a sensitivity of 0.87 (95% CI: 0.73-0.94) and a specificity of 0.93 (95% CI: 0.84-0.97). For SUVmax, the summary sAUC was 0.95 (95% CI: 0.93-0.96), with a sensitivity of 0.80 (95% CI: 0.63-0.91) and a specificity of 0.94 (95% CI: 0.87-0.97).
The authors noted limitations, including stratified analyses that indicated potential influence from the neoadjuvant treatment regimen (single-modality vs. combination therapy) and incomplete data on cut-off values. Safety data were not reported.
The practice relevance was not reported. The analysis does not infer causality from diagnostic accuracy metrics and does not assume specific treatment regimens beyond what is mentioned in stratified analyses.
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View Original Abstract ↓
ObjectiveTo comprehensively evaluate the diagnostic utility of metabolic parameter changes on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for predicting pathological response after neoadjuvant therapy in patients with non-small cell lung cancer (NSCLC).MethodsThe Cochrane Library, Web of Science, Embase, and PubMed were comprehensively retrieved up until October 2024 to identify diagnostic test accuracy studies evaluating the predictive efficacy of 18F-FDG PET/CT for postoperative pathological response in NSCLC patients following neoadjuvant therapy. Two independent reviewers screened studies, collected information, and evaluated the risk of bias. Statistical analysis was conducted via Meta-Disc 1.4 and Stata 17.0 software.ResultsFourteen eligible investigations encompassing 1,315 subjects were incorporated. The findings revealed that for predicting major pathological response (MPR) after neoadjuvant therapy, the metabolic parameter ΔSUVmax% on 18F-FDG PET/CT achieved an area under the summary receiver operating characteristic curve (sAUC) of 0.96 (95% CI: 0.94-0.97), with pooled sensitivity and specificity of 0.87 (0.73-0.94) and 0.93 (0.84-0.97), respectively. Similarly, the parameter SUVmax itself yielded an sAUC of 0.95 (0.93-0.96), with sensitivity of 0.80 (0.63-0.91) and specificity of 0.94 (0.87-0.97). Stratified analyses indicated that the neoadjuvant treatment regimen (single-modality vs. combination therapy), the cut-off value (
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