OBJECTIVES To evaluate the diagnostic test accuracy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), whole-body magnetic resonance imaging (WB-MRI), and whole-body diffusion-weighted imaging (WB-DWI) for the detection of metastases in patients with non-small cell lung cancer (NSCLC). METHODS MEDLINE, Embase, and Cochrane Library databases were searched up to June 2019. Studies were selected if they reported data that could be used to construct contingency tables to compare 18F-FDG PET/CT, WB-MRI, and WB-DWI. Two authors independently extracted data on study characteristics and assessed methodological quality using the Quality Assessment of Diagnostic Accuracy Studies. Forest plots were generated for sensitivity and specificity of 18F-FDG PET/CT, WB-MRI, and whole-body diffusion-weighted imaging (WB-DWI). Summary receiver operating characteristic plots were created. RESULTS The 4 studies meeting inclusion criteria had a total of 564 patients and 559 lesions, 233 of which were metastases. In studies of 18F-FDG PET/CT, the pooled estimates of sensitivity and specificity were 0.83 (95% confidence interval [CI], 0.54-0.95) and 0.93 (95% CI, 0.87-0.96), respectively. For WB-MRI, pooled sensitivity was 0.92 (95% CI, 0.18-1.00) and pooled specificity was 0.93 (95% CI, 0.85-0.95). Pooled sensitivity and specificity for WB-DWI were 0.78 (95% CI, 0.46-0.93) and 0.91 (95% CI, 0.79-0.96), respectively. There was no statistical difference between the diagnostic odds ratio of WB-MRI and WB-DWI compared with that of PET/CT (p = 0.186 for WB-DWI; p = 0.638 for WB-MRI). CONCLUSION WB-MRI and DWI are radiation-free alternatives with comparable diagnostic performance to 18F-FDG PET/CT for M staging of NSCLC. KEY POINTS • Whole-body MRI with or without diffusion-weighted imaging has a high accuracy for the diagnostic evaluation of metastases in patients with non-small cell lung cancer. • Whole-body MRI may be used as a non-invasive and radiation-free alternative to positron emission tomography with CT with similar diagnostic performance.

中文翻译：

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18F-FDG PET / CT和全身MRI诊断非小细胞肺癌的M分期：系统评价和荟萃分析。

目的评估18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET / CT），全身磁共振成像（WB-MRI）和全身扩散加权成像（WB-DWI）的诊断测试准确性），用于检测非小细胞肺癌（NSCLC）患者的转移情况。方法检索截至2019年6月的MEDLINE，Embase和Cochrane图书馆数据库。如果研究报告的数据可用于构建列队表以比较18F-FDG PET / CT，WB-MRI和WB-DWI，则选择该研究。两位作者使用诊断准确性研究的质量评估独立提取了研究特征的数据并评估了方法学质量。针对18F-FDG PET / CT，WB-MRI和全身扩散加权成像（WB-DWI）的敏感性和特异性生成了森林图。创建了摘要接收器工作特性图。结果符合入选标准的4项研究共564例患者和559个病变，其中233个为转移灶。在18F-FDG PET / CT的研究中，敏感性和特异性的合并估计分别为0.83（95％置信区间[CI]，0.54-0.95）和0.93（95％CI，0.87-0.96）。对于WB-MRI，合并敏感性为0.92（95％CI，0.18-1.00），合并特异性为0.93（95％CI，0.85-0.95）。WB-DWI的合并敏感性和特异性分别为0.78（95％CI，0.46-0.93）和0.91（95％CI，0.79-0.96）。与PET / CT相比，WB-MRI和WB-DWI的诊断优势比没有统计学差异（WB-DWI的p = 0.186； WB-MRI的p = 0.638）。结论WB-MRI和DWI是无辐射的替代方案，其M分期的NSCLC诊断性能与18F-FDG PET / CT相当。要点•进行或不进行弥散加权成像的全身MRI对非小细胞肺癌患者转移的诊断评估具有很高的准确性。•全身MRI可以用作具有类似诊断性能的CT正电子发射断层扫描的无创且无辐射替代品。