Tara Pereiro Brea1, Alberto Ruano Raviña2, José Martín Carreira Villamor3, Antonio Golpe Gómez4, Anxo Martínez de Alegría3, Luís Valdés5. 1. University Hospital Complex, Pneumology Service, Santiago de Compostela, Spain. Electronic address: tpereirobrea@gmail.com. 2. Medicine School. University of Santiago. Area of Preventive Medicine and Public Health, Santiago de Compostela, Spain; CIBER of Epidemiology and Public Health. CIBERESP, Madrid, Spain. 3. University Hospital Complex, Radiology Service, Santiago de Compostela, Spain. 4. University Hospital Complex, Pneumology Service, Santiago de Compostela, Spain. 5. University Hospital Complex, Pneumology Service, Santiago de Compostela, Spain; Interdisciplinary Group of Research in Pneumology, Institute of Sanitary Investigations in Santiago (IDIS), Santiago de Compostela, Spain.
Abstract
INTRODUCTION: The aim of this study is to assess the diagnostic value of the magnetic resonance imaging (MRI) in differentiating metastasic from non-metastatic lymph nodes in NSCLC patients compared with computed tomography (CT) and fluorodeoxyglucose (FDG) - positron emission tomography (PET) or both combined. METHODS: Twenty-three studies (19 studies and 4 meta-analysis) with sample size ranging between 22 and 250 patients were included in this analysis. MRI, regardless of the sequence obtained, where used for the evaluation of N-staging of NSCLC. Histopathology results and clinical or imaging follow-up were used as the reference standard. Studies were excluded if the sample size was less than 20 cases, if less than 10 lymph nodes assessment were presented or studies where standard reference was not used. Papers not reporting sufficient data were also excluded. RESULTS: As compared to CT and PET, MRI demonstrated a higher sensitivity, specificity and diagnostic accuracy in the diagnosis of metastatic or non-metastatic lymph nodes in N-staging in NSCLC patients. No study considered MRI inferior than conventional techniques (CT, PET or PET/CT). Other outstanding results of this review are fewer false positives with MRI in comparison with PET, their superiority over PET/CT to detect non-resectable lung cancer, to diagnosing infiltration of adjacent structures or brain metastasis and detecting small nodules. CONCLUSION: MRI has shown at least similar or better results in diagnostic accuracy to differentiate metastatic from non-metastatic mediastinal lymph nodes. This suggests that MRI could play a significant role in mediastinal NSCLC staging.
INTRODUCTION: The aim of this study is to assess the diagnostic value of the magnetic resonance imaging (MRI) in differentiating metastasic from non-metastatic lymph nodes in NSCLCpatients compared with computed tomography (CT) and fluorodeoxyglucose (FDG) - positron emission tomography (PET) or both combined. METHODS: Twenty-three studies (19 studies and 4 meta-analysis) with sample size ranging between 22 and 250 patients were included in this analysis. MRI, regardless of the sequence obtained, where used for the evaluation of N-staging of NSCLC. Histopathology results and clinical or imaging follow-up were used as the reference standard. Studies were excluded if the sample size was less than 20 cases, if less than 10 lymph nodes assessment were presented or studies where standard reference was not used. Papers not reporting sufficient data were also excluded. RESULTS: As compared to CT and PET, MRI demonstrated a higher sensitivity, specificity and diagnostic accuracy in the diagnosis of metastatic or non-metastatic lymph nodes in N-staging in NSCLCpatients. No study considered MRI inferior than conventional techniques (CT, PET or PET/CT). Other outstanding results of this review are fewer false positives with MRI in comparison with PET, their superiority over PET/CT to detect non-resectable lung cancer, to diagnosing infiltration of adjacent structures or brain metastasis and detecting small nodules. CONCLUSION: MRI has shown at least similar or better results in diagnostic accuracy to differentiate metastatic from non-metastatic mediastinal lymph nodes. This suggests that MRI could play a significant role in mediastinal NSCLC staging.
Authors: Tara Pereiro-Brea; Antonio Golpe-Gómez; Antonio Miguel Golpe-Sánchez; Luís Valdés; Anxo Martínez de Alegría; José Martín Carreira-Villamor; Alberto Ruano-Raviña Journal: Can Respir J Date: 2020-06-05 Impact factor: 2.409