The utility of 18F-FDG PET/CT for the diagnosis of adrenal metastasis in lung cancer

OBJECTIVES: The aim of the present meta-analysis was to systematically evaluate the overall diagnostic accuracy of F-FDG PET/CT for the detection of adrenal metastasis in lung cancer. PATIENTS AND METHODS: A comprehensive literature search of Medline (PubMed), Embase, Web of Science, Cochrane, and China National Knowledge Infrastructure databases published through 10 January 2017 on the role of F-FDG PET/CT in evaluating adrenal mass in lung cancer patients was performed. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of F-FDG PET/CT on a per lesion-based analysis were calculated. The area under the curve was calculated to measure the accuracy of F-FDG PET/CT. RESULTS: A total of nine studies, involving 707 lung cancer patients with 810 adrenal masses, were included in the present meta-analysis. Of 810 adrenal masses from lung cancer, 411 (50.7%) and 399 (49.3%) masses were benign and metastatic, respectively. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of F-FDG PET/CT were 0.887 [95% confidence interval (CI): 0.852-0.917], 0.908 (95% CI: 0.875-0.934), 8.552 (95% CI: 6.197-11.802), 0.090 (95% CI: 0.039-0.211), and 96.825 (95% CI: 40.402-232.05), respectively. In addition, the area under the curve was 0.9622 and the overall diagnostic accuracy (Q* index) was 0.9077, suggesting excellent performance. CONCLUSION: F-FDG PET/CT plays a vital role in the differentiation of adrenal metastasis from a benign adrenal mass in lung cancer patients, with excellent diagnostic performance.