Dynamic contrast–enhanced computed tomography for the diagnosis of solitary pulmonary nodules: a systematic review and meta-analysis

Weir-McCall, Jonathan R., Joyce, Stella, Clegg, Andrew, Mackay, James, Baxter, Gabrielle, Dendl, Lena-Marie, Rintoul, Robert C., Qureshi, Nagmi, Miles, Ken and Gilbert, Fiona J. (2020) Dynamic contrast–enhanced computed tomography for the diagnosis of solitary pulmonary nodules: a systematic review and meta-analysis. European Radiology, 30 (6). 3310–3323. ISSN 0938-7994

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Abstract

Introduction A systematic review and meta-analysis were performed to determine the diagnostic performance of dynamic contrast–enhanced computed tomography (DCE-CT) for the differentiation between malignant and benign pulmonary nodules. Methods Ovid MEDLINE and EMBASE were searched for studies published up to October 2018 on the diagnostic accuracy of DCE-CT for the characterisation of pulmonary nodules. For the index test, studies with a minimum of a pre- and post-contrast computed tomography scan were evaluated. Studies with a reference standard of biopsy for malignancy, and biopsy or 2-year follow-up for benign disease were included. Study bias was assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). The sensitivities, specificities, and diagnostic odds ratios were determined along with 95% confidence intervals (CIs) using a bivariate random effects model. Results Twenty-three studies were included, including 2397 study participants with 2514 nodules of which 55.3% were malignant (1389/2514). The pooled accuracy results were sensitivity 94.8% (95% CI 91.5; 96.9), specificity 75.5% (69.4; 80.6), and diagnostic odds ratio 56.6 (24.2–88.9). QUADAS 2 assessment showed intermediate/high risk of bias in a large proportion of the studies (52–78% across the domains). No difference was present in sensitivity or specificity between subgroups when studies were split based on CT technique, sample size, nodule size, or publication date. Conclusion DCE-CT has a high diagnostic accuracy for the diagnosis of pulmonary nodules although study quality was indeterminate in a large number of cases.

Item Type: Article
Uncontrolled Keywords: contrast media,lung cancer,meta-analysis,multi-detector computed tomography,solitary pulmonary nodule,radiology nuclear medicine and imaging ,/dk/atira/pure/subjectarea/asjc/2700/2741
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 20 Feb 2020 07:57
Last Modified: 30 Jul 2020 23:53
URI: https://ueaeprints.uea.ac.uk/id/eprint/74264
DOI: 10.1007/s00330-020-06661-8

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