Imaging for the Pretreatment Staging of Small cell Lung Cancer: A Systematic Review

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• 作者：Matthew D. Mitchell ; PhD^a ; ^b ; ¹ ; ^{mdmitchell@uphs.upenn.edu" class="auth_mail" title="E-mail the corresponding author} ; Charu Aggarwal ; MD ; MPH^c ; ¹ ; Amy Y. Tsou ; MD ; MSc^b ; ^d ; Drew A. Torigian ; MD ; MA ; FSAR^e ; Jonathan R. Treadwell ; PhD^b ; ^d
• 关键词：Small cell lung cancer (SCLC) ; neoplasm staging ; positron emission tomography/computed tomography (PET/CT) ; magnetic resonance imaging (MRI) ; computed tomography (CT)
• 刊名：Academic Radiology
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：23
• 期：8
• 页码：1047-1056
• 全文大小：650 K

文摘

Small cell lung cancer (SCLC) is an aggressive form of lung cancer. Accurate staging is essential to select the optimal treatment plan to maximize survival. No consensus exists on standard imaging modalities for pretreatment staging of SCLC.

Materials and Methods

We conducted a systematic review of the literature on imaging modalities in the pretreatment staging of SCLC. A systematic search of multiple databases identified relevant studies published from 2000 through June 2015. Outcomes of interest included test concordance, staging accuracy (sensitivity and specificity), choice of treatment, timeliness of treatment, and patient outcomes.

Results

The search identified 2880 citations; 7 studies met inclusion criteria, n = 408 patients. Six of the seven studies were deemed to have moderate risk of bias, and one was deemed to have high risk of bias. One of the studies reported test concordance, three studies reported comparative accuracy of testing strategies, and four studies reported the accuracy of a single imaging modality. Analysis from these studies revealed that fluorodeoxyglucose–positron emission tomography/computed tomography (FDG-PET/CT) is more sensitive than multidetector CT for detecting osseous metastases, more sensitive than bone scintigraphy for detecting osseous metastases, and more sensitive for detecting any distant metastases.

Conclusions

Evidence is sparse on the use of imaging in the pretreatment staging of SCLC. There is a lack of evidence on patient-oriented outcomes and a lack of evidence on whether comparative accuracy or effectiveness is associated with patient factors. We found low-strength evidence suggesting that FDG-PET/CT is more sensitive than CT and bone scintigraphy for detecting osseous metastases.