Thoracic staging in patients with non-small cell lung cancer: A systematic review and meta-analysis on diagnostic accuracy of [18F]FDG PET/MRI and [18F]FDG PET/CT

Background: This study aimed to evaluate the diagnostic accuracy of [18F]FDG PET/MR versus [18F]FDG PET/CT in the thoracic staging of patients with non-small cell lung cancer (NSCLS).

Material and methods: The Preferred Reporting Items for Systematic Reviews (PRISMA) were followed in conducting the present study. All available research was collected through Embase (Elsevier), PubMed, as well as Cochrane Library databases up to June 2021. Only studies covering both [18F]FDG PET/MRI and [18F]FDG PET/CT techniques in the same group were included. Statistical analysis was done using Stata v.12.

Results: The overall accuracy of [18F]FDG PET/CT in T and N staging was 92% (95% CI: 89-95 , I2 : 93.4%) and 78% (95% CI: 74-82 , I2 : 98.5%) respectively. While, the corresponding rates for [18F]FDG PET/MRI were 91% (95% CI: 88-94 , I2 : 96.5%) and 89% (95% CI: 84-94 , I2 : 88.1%) respectively.

Conclusions: The present meta-analysis showed that [18F]FDG PET/CT and [18F]FDG PET/MRI exhibit relatively the same performance in detecting N and T stages in patients with NSCLC. Thus, [18F]FDG PET/MRI can be a worthy alternative for [18F]FDG PET/CT in the diagnosis of advanced of NSCLC in the chest area, more specifically in N-staging, since it provides higher soft-tissue contrast. There is a need for more reliable research for comparing the diagnostic performance of these imaging techniques and various optimized [18F]FDG PET/MRI protocols.