Predictive value of 18F‐fluorodeoxyglucose positron emission tomography/computed tomography for PD‐L1 expression in non‐small cell lung cancer: A systematic review and meta‐analysis
Hee Yun Seol, Yun Seong Kim, Seong‐Jang Kim
Abstract
BACKGROUND: The purpose of the current study was to investigate the predictive value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for programmed death ligand 1 (PD-L1) in non-small cell lung cancer (NSCLC) patients through a systematic review and meta-analysis. METHODS: The PubMed, Cochrane, and EMBASE database, from the earliest available date of indexing through 30 April 2020, were searched for studies evaluating the diagnostic performance of 18F-FDG PET/CT for prediction of PD-L1 expression in NSCLC patients. RESULTS: = 77.9, P < 0.001). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR +) of 2.3 (95% CI: 1.8-2.9) and negative likelihood ratio (LR-) of 0.41 (95% CI: 0.26-0.63). The pooled diagnostic odds ratio (DOR) was six (95% CI: 3-11). Hierarchical summary receiver operating characteristic (ROC) curve indicated that the area under the curve was 0.74 (95% CI: 0.70-0.78). CONCLUSIONS: The current meta-analysis showed a moderate sensitivity and specificity of 18F-FDG PET/CT for the prediction of PD-L1 expression in NSCLC patients. The DOR was low and the likelihood ratio scatter-gram indicated that 18F-FDG PET/CT might not be useful for the prediction of PD-L1 expression in NSCLC patients and not for its exclusion. KEY POINTS: Significant findings of the study The current meta-analysis showed a moderate sensitivity and specificity of 18F-FDG PET/CT for the prediction of PD-L1 expression in NSCLC patients. The DOR was low and the likelihood ratio scattergram indicated that 18F-FDG PET/CT might not be useful for the prediction of PD-L1 expression in NSCLC patients and not for its exclusion. What this study adds This study concluded that the role of 18F-FDG PET/CT in predicting tumor expression of PD-L1 should be further elucidated.