Key Points
• Some research has suggested that a higher uptake of 18F-FDG is predictive of mutant EGFR in the context of NSCLC. Overall, however, findings on the topic are mixed, In the current BMC systematic review and meta-analysis, authors attempted to elucidate.
• “Our meta-analysis results showed that 18F-FDG PET/CT had low pooled sensitivity and specificity for EGFR mutation prediction,” the authors concluded. “The low DOR and the likelihood ratio scatter plot indicated that 18F-FDG PET/CT might not be useful—or, at least, that it should be used with caution—for predicting EGFR mutations in patients with NSCLC.”
• A strength of this study involved the initial analysis of conflicting results via pooled weighted mean difference (WMD) analysis, thus refining the meta-analysis. The main limitation is heterogeneity, according to the authors. Notably, heterogeneity (e.g., NSCLC subtypes such as lung adenocarcinoma) was addressed via a random effects model. Another limitation was the use of the index SUVmax, which although the most commonly used and stable index, is affected by tumor size, glucose level, and image acquisition and reconstruction—particularly with different PET/CT equipment involving different acquisition settings. Finally, there were limited numbers of (high-quality) studies included for subgroup analysis.