Comparison of the diagnostic performance of F-fluorothymidine versus F-fluorodeoxyglucose positron emission tomography on pulmonary lesions: A meta analysis.

A pulmonary lesion is an extremely common and clinically challenging disorder worldwide, and an accurate diagnosis of lung cancer is crucial for early treatment and management. The aim of the present study was to perform a comprehensive meta analysis to compare the diagnostic performance of F-fluorothymidine (F-FLT) positron emission tomography (PET) with F-fluorodeoxyglucose (F-FDG) PET in evaluating patients with pulmonary lesions. Relevant studies were identified using the PubMed, EMBASE and Cochrane library databases. The pooled estimated sensitivity, specificity, positive-likelihood ratio, negative-likelihood ratio, and diagnostic odds ratio (DOR) for F-FLT PET versus F-FDG PET were calculated as the main outcome measures. Summary receiver operating characteristic curves were also constructed by Meta-Disk 1.4 software using a Mose's constant of linear model. The meta analysis showed that F-FLT PET had a higher specificity (0.70; 95% CI, 0.61-0.77), but lower sensitivity (0.81; 95% CI, 0.74-0.87) compared to F-FDG PET (0.50; 95% CI, 0.41-0.58 for specificity; 0.92; 95% CI 0.86-0.95 for sensitivity). For DOR, F-FLT PET (12.58; 95% CI, 6.81-23.24) was higher compared to F-FDG PET (10.72; 95% CI, 5.51-20.87). The area under the curve was 0.8592 and 0.9240 for F-FLT PET and F-FDG PET, respectively (Z=0.976, P>0.05). In conclusion, F-FLT PET and F-FDG PET had good diagnostic performance for the overall assessment of pulmonary lesions, and F-FLT PET had a higher specificity compared to F-FDG PET, but was less sensitive than F-FDG PET. Therefore, F-FLT and F-FDG together could add diagnostic confidence for pulmonary lesions.