Tae-Hyung Kim1, Sungmin Woo2, Darragh F Halpenny3, Yeon Joo Kim4, Soon Ho Yoon5, Chong Hyun Suh6. 1. Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Radiology, Naval Pohang Hospital, Pohang, Republic of Korea. 2. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. Electronic address: woos@mskcc.org. 3. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. 4. Department of Radiation Oncology, Kangwon National University Hospital, Chuncheon, Republic of Korea. 5. Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. 6. Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul, Republic of Korea.
Abstract
PURPOSE: To perform a systematic review and meta-analysis evaluating usefulness of high-risk CT features (HRFs) on follow-up CT in detecting local recurrence after stereotactic body radiation therapy (SBRT) in lung cancer patients. METHODS: Pubmed and EMBASE were searched up to January 11th, 2019. We included studies that differentiated local recurrence from post-SBRT changes after SBRT on follow-up CT in lung cancer patients. Methodological quality was assessed using QUADAS-2. The association between HRFs and local recurrence were pooled in the form of odds ratio (OR) using the random effects model. Heterogeneity was examined by the Inconsistency index (I2). RESULTS: Eight studies were included, consisting of 356 lung cancer patients. The overall prevalence of patients with local recurrence was 18.8 % (67/356). Compared with post-SBRT changes, local recurrence after SBRT more frequently demonstrated air-bronchogram disappearance (OR = 7.15), bulging margin (OR = 24.12), craniocaudal growth (OR = 26.07), enlargement after 12 months (OR = 28.11), enlarging opacity (OR = 7.92), linear margin disappearance (OR = 29.24), and sequential enlargement (OR = 83.23) (p ≤ 0.02). Pleural effusion appearance was not related with local recurrence (p = 0.82). Heterogeneity varied among HRFs (I2 = 0-91 %). The quality of the studies was considered moderate. CONCLUSIONS: Several HRFs on follow-up CT after SBRT were useful in suggesting local recurrence. These HRFs may help raise clinical suspicion of local recurrence, initiate prompt additional test for confirmation and perform subsequent proper personalized salvage treatment.
PURPOSE: To perform a systematic review and meta-analysis evaluating usefulness of high-risk CT features (HRFs) on follow-up CT in detecting local recurrence after stereotactic body radiation therapy (SBRT) in lung cancerpatients. METHODS: Pubmed and EMBASE were searched up to January 11th, 2019. We included studies that differentiated local recurrence from post-SBRT changes after SBRT on follow-up CT in lung cancerpatients. Methodological quality was assessed using QUADAS-2. The association between HRFs and local recurrence were pooled in the form of odds ratio (OR) using the random effects model. Heterogeneity was examined by the Inconsistency index (I2). RESULTS: Eight studies were included, consisting of 356 lung cancerpatients. The overall prevalence of patients with local recurrence was 18.8 % (67/356). Compared with post-SBRT changes, local recurrence after SBRT more frequently demonstrated air-bronchogram disappearance (OR = 7.15), bulging margin (OR = 24.12), craniocaudal growth (OR = 26.07), enlargement after 12 months (OR = 28.11), enlarging opacity (OR = 7.92), linear margin disappearance (OR = 29.24), and sequential enlargement (OR = 83.23) (p ≤ 0.02). Pleural effusion appearance was not related with local recurrence (p = 0.82). Heterogeneity varied among HRFs (I2 = 0-91 %). The quality of the studies was considered moderate. CONCLUSIONS: Several HRFs on follow-up CT after SBRT were useful in suggesting local recurrence. These HRFs may help raise clinical suspicion of local recurrence, initiate prompt additional test for confirmation and perform subsequent proper personalized salvage treatment.
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