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dc.contributor.authorWeir-McCall, Jonathanen
dc.contributor.authorJoyce, Stellaen
dc.contributor.authorClegg, Andrewen
dc.contributor.authorMacKay, Jamesen
dc.contributor.authorBaxter, Gabrielleen
dc.contributor.authorDendl, Lena-Marieen
dc.contributor.authorRintoul, Roberten
dc.contributor.authorQureshi, Nagmi Ren
dc.contributor.authorMiles, Kenen
dc.contributor.authorGilbert, Fionaen
dc.date.accessioned2020-02-21T00:30:18Z
dc.date.available2020-02-21T00:30:18Z
dc.identifier.issn0938-7994
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/302451
dc.description.abstractINTRODUCTION: 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. KEY POINTS: • The pooled accuracy results were sensitivity 95.1% and specificity 73.8% although individual studies showed wide ranges of values. • This is comparable to the results of previous meta-analyses of PET/CT (positron emission tomography/computed tomography) diagnostic accuracy for the diagnosis of solitary pulmonary nodules. • Robust direct comparative accuracy and cost-effectiveness studies are warranted to determine the optimal use of DCE-CT and PET/CT in the diagnosis of SPNs.
dc.languageengen
dc.publisherSpringer Nature
dc.rightsAll rights reserved
dc.subjectContrast mediaen
dc.subjectLung canceren
dc.subjectMeta-analysisen
dc.subjectMulti-detector computed tomographyen
dc.subjectSolitary pulmonary noduleen
dc.titleDynamic contrast-enhanced computed tomography for the diagnosis of solitary pulmonary nodules: a systematic review and meta-analysis.en
dc.typeArticle
prism.publicationNameEuropean Radiologyen
dc.identifier.doi10.17863/CAM.49522
dcterms.dateAccepted2020-01-17en
rioxxterms.versionofrecord10.1007/s00330-020-06661-8en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2020-01-17en
dc.contributor.orcidWeir-McCall, Jonathan [0000-0001-5842-842X]
dc.contributor.orcidMacKay, James [0000-0001-7558-3800]
dc.contributor.orcidBaxter, Gabrielle [0000-0002-8242-1559]
dc.contributor.orcidRintoul, Robert [0000-0003-3875-3780]
dc.contributor.orcidGilbert, Fiona [0000-0002-0124-9962]
dc.identifier.eissn1432-1084
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idNational Institute for Health Research (NIHR) (via University of Southampton) (511640101)
cam.issuedOnline2020-02-15en
cam.orpheus.successTue Mar 31 10:35:48 BST 2020 - Embargo updated*
rioxxterms.freetoread.startdate2021-02-15


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