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Wang Y, Duan Y, Guo D, Lv H, Li Q, Liu X, Qiao N, Meng H, Zhang X, Lan L, Liu X, Liu X. Value of circulating tumor cell assisting low-dose computed tomography in screening pulmonary nodules based on existing liquid biopsy techniques: a systematic review with meta-analysis and trial sequential analysis. Clin Transl Oncol 2024:10.1007/s12094-024-03556-8. [PMID: 38869739 DOI: 10.1007/s12094-024-03556-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 06/04/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE This study aims to assess the diagnostic utility of circulating tumor cells (CTCs) in conjunction with low-dose computed tomography (LDCT) for differentiating between benign and malignant pulmonary nodules and to substantiate the foundation for their integration into clinical practice. METHODS A systematic literature review was performed independently by two researchers utilizing databases including PubMed, Web of Science, The Cochrane Library, Embase, and Medline, to collate studies up to September 15, 2023, that investigated the application of CTCs in diagnosing pulmonary nodules. A meta-analysis was executed employing Stata 15.0 and Revman 5.4 to calculate the pooled sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), diagnostic odds ratio (DOR), and the area under the receiver operating characteristic curve (AUC). Additionally, trial sequential analysis was conducted using dedicated TSA software. RESULTS The selection criteria identified 16 studies, encompassing a total of 3409 patients. The meta-analysis revealed that CTCs achieved a pooled sensitivity of 0.84 (95% CI 0.80 to 0.87), specificity of 0.80 (95% CI 0.73 to 0.86), PLR of 4.23 (95% CI 3.12 to 5.72), NLR of 0.20 (95% CI 0.16 to 0.25), DOR of 20.92 (95% CI 13.52 to 32.36), and AUC of 0.89 (95% CI 0.86 to 0.93). CONCLUSIONS Circulating tumor cells demonstrate substantial diagnostic accuracy in distinguishing benign from malignant pulmonary nodules. The incorporation of CTCs into the diagnostic protocol can significantly augment the diagnostic efficacy of LDCT in screening for malignant lung diseases.
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Affiliation(s)
- Yixian Wang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Yuqing Duan
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Dingjie Guo
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Hongbo Lv
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Qiong Li
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Xuan Liu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Na Qiao
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Hengyu Meng
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Xin Zhang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Linwei Lan
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Xiumin Liu
- Department of Clinical Laboratory, The Second Hospital of Jilin University, Changchun, Jilin, 130041, China.
| | - Xin Liu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, 130021, China.
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Noto B, Roll W, Zinken L, Rischen R, Kerschke L, Evers G, Heindel W, Schäfers M, Büther F. Respiratory motion correction in F-18-FDG PET/CT impacts lymph node assessment in lung cancer patients. EJNMMI Res 2022; 12:61. [PMID: 36107357 PMCID: PMC9478021 DOI: 10.1186/s13550-022-00926-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/19/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUNDS Elastic motion correction in PET has been shown to increase image quality and quantitative measurements of PET datasets affected by respiratory motion. However, little is known on the impact of respiratory motion correction on clinical image evaluation in oncologic PET. This study evaluated the impact of motion correction on expert readers' lymph node assessment of lung cancer patients. METHODS Forty-three patients undergoing F-18-FDG PET/CT for the staging of suspected lung cancer were included. Three different PET reconstructions were investigated: non-motion-corrected ("static"), belt gating-based motion-corrected ("BG-MC") and data-driven gating-based motion-corrected ("DDG-MC"). Assessment was conducted independently by two nuclear medicine specialists blinded to the reconstruction method on a six-point scale [Formula: see text] ranging from "certainly negative" (1) to "certainly positive" (6). Differences in [Formula: see text] between reconstruction methods, accounting for variation caused by readers, were assessed by nonparametric regression analysis of longitudinal data. From [Formula: see text], a dichotomous score for N1, N2, and N3 ("negative," "positive") and a subjective certainty score were derived. SUV and metabolic tumor volumes (MTV) were compared between reconstruction methods. RESULTS BG-MC resulted in higher scores for N1 compared to static (p = 0.001), whereas DDG-MC resulted in higher scores for N2 compared to static (p = 0.016). Motion correction resulted in the migration of N1 from tumor free to metastatic on the dichotomized score, consensually for both readers, in 3/43 cases and in 2 cases for N2. SUV was significantly higher for motion-corrected PET, while MTV was significantly lower (all p < 0.003). No significant differences in the certainty scores were noted. CONCLUSIONS PET motion correction resulted in significantly higher lymph node assessment scores of expert readers. Significant effects on quantitative PET parameters were seen; however, subjective reader certainty was not improved.
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Affiliation(s)
- Benjamin Noto
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany ,grid.16149.3b0000 0004 0551 4246Clinical for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Wolfgang Roll
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Laura Zinken
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Robert Rischen
- grid.16149.3b0000 0004 0551 4246Clinical for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Laura Kerschke
- grid.5949.10000 0001 2172 9288Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - Georg Evers
- grid.16149.3b0000 0004 0551 4246Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Münster, Münster, Germany
| | - Walter Heindel
- grid.16149.3b0000 0004 0551 4246Clinical for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany ,West German Cancer Centre (WTZ), Münster, Germany
| | - Michael Schäfers
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany ,grid.5949.10000 0001 2172 9288European Institute for Molecular Imaging, University of Münster, Münster, Germany ,West German Cancer Centre (WTZ), Münster, Germany
| | - Florian Büther
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany ,grid.5949.10000 0001 2172 9288European Institute for Molecular Imaging, University of Münster, Münster, Germany
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