Table 1. An evaluation of tumour (T), nodal (N) and metastatic (M) staging using MRI versus CT or F-18-FDG PET for lung cancer patients.
| Reference and study design | Number of patients | Staging focus | Pathological correlation | Imaging modality | Key results |
|---|---|---|---|---|---|
| Kajiwara et al. 2010 (16), Retrospective | 100 | T staging—chest wall invasion | All had surgery | CT versus dynamic cine MRI | Sensitivity for T staging: CT 60.0%, MRI 100%, P=ND. Specificity for T staging: CT 43.9%, MRI 68.5%, P=ND |
| Padovani et al. 1993 (17), Prospective | 34 | T staging—chest wall invasion | 27/34 surgery. Others had invasion confirmed by lytic disease on CT | CT versus MRI (T1 and T2) | Quantifying detection of parietal invasion: sensitivity (CT 45%, MRI 90%); specificity (CT 100%, MRI 86%) |
| Musset et al. 1986 (18), Prospective | 44 | T staging—chest wall invasion | All had surgery | CT versus MRI (T1 and T2) | Sensitivity for T staging: CT 53%, MRI 60%, P>0.05. Specificity for T staging: CT 97%, MRI 93%, P>0.05 |
| Heelan et al. 1989 (11), Prospective | 31 | T staging—superior sulcus tumours | 15/31 surgery. Others had symptoms of invasion | CT versus MRI (T1 and T2) | Quantifying invasion into the lower neck: sensitivity (CT 60%, MRI 88%, P= ND); specificity (CT 65%, MRI 100%, P=ND) |
| Wu et al. 2012 (19), Meta-analysis | 2,845 | N staging | All had surgery | PET versus MRI (DW-MRI) | Pooled sensitivity for N staging: 18-FDG PET-CT 0.75 (95% CI: 0.68–0.81); DW-MRI 0.72 (95% CI: 0.63–0.80, P=0.09). Pooled specificity for N staging: 18-FDG PET-CT 0.89 (95% CI: 0.85–0.91); DW-MRI 0.95 (95% CI: 0.85–0.98, P=0.02) |
| Shen et al. 2017 (20), Meta-analysis | DWI 802; 18-FDG PET-CT >4,000 | N staging | All had surgery | PET versus MRI (DW-MRI) | Pooled sensitivity of N staging: 18-FDG PET-CT 0.65 (95% CI: 0.67–0.67); DW-MRI 0.72 (95% CI: 0.68–0.76, P>0.05). Pooled specificity of N staging: 18-FDG PET-CT 0.93 (95% CI: 0.93–0.94); DW-MRI 0.97 (95% CI: 0.96–0.98, P>0.05) |
| Zhang et al. 2015, Meta-analysis (21) | STIR 545; DWI 383 | N staging | All had surgery | STIR and DW-MRI versus pathology | Pooled sensitivity for N staging: STIR 0. 84 (95% CI: 0.78–0.89); DW-MRI 0.69 (95% CI: 0.61–0.77) P=ND. Pooled specificity for N staging: STIR 0.91 (95% CI: 0.87–0. 94); DW-MRI 0.93 (95% CI: 0.89–0.96) P=ND |
| Yi et al. 2008 (22), Prospective | 154 | M staging | All had surgery with follow up imaging for M status | 18-FDG PET-CT and whole body 3.0 T MR imaging | Sensitivity for M staging: 18-FDG PET-CT 0.48; whole body MR 0.52 (P>0.99). Specificity for M staging: 18-FDG PET-CT 0.96; whole body MR 0.95 (P=0.625) |
| Yi et al. 2013 (23), Prospective | 263: 143 WB MRI-PET; 120 WB 18-FDG PET-CT plus MRI brain | T staging | All had surgery with follow up imaging for M staging | Whole body 18-FDG PET-CT and MRI brain versus whole body (WB) MRI-PET; 1.5 T | Number and percentage (%) of patients correctly upstaged with: 18-FDG PET-CT plus brain MRI 0/26 (0%); WB MRI-PET 5/37 (13.5%) |
| N staging | Number and percentage (%) of patients correctly upstaged with N2/N3 nodal disease: 18-FDG PET-CT plus brain MRI 8/26 (30.8%); WB MRI-PET 12/36 (33%) | ||||
| M staging | Number and percentage (%) of patients correctly upstaged with metastatic disease: 18-FDG PET-CT plus brain MRI 15/26 (57.7%); WB MRI-PET 13/37 (35.1%) |
ND, not documented; MRI, magnetic resonance imaging; DWI, diffusion weighted imaging; STIR, Short T1 Inversion Recovery.