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Cochrane Database of Systematic Reviews

PET‐CT for assessing mediastinal lymph node involvement in patients with suspected resectable non‐small cell lung cancer

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DOI:
https://doi.org/10.1002/14651858.CD009519Copy DOI
Database:
  1. Cochrane Database of Systematic Reviews
Version published:
  1. 07 December 2011see what's new
Type:
  1. Diagnostic
Stage:
  1. Protocol
Cochrane Editorial Group:
  1. Cochrane Lung Cancer Group

Copyright:
  1. Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Authors

  • Mia Schmidt‐Hansen

    Correspondence to: National Collaborating Centre for Cancer, Cardiff, UK

    [email protected]

  • David R Baldwin

    Adult Cystic Fibrosis Unit, Nottingham University Hospitals, City Campus, Nottingham, UK

  • Elise Collins

    National Collaborating Centre for Cancer, Cardiff, UK

  • Javier Zamora

    (a) Unidad de Bioestadística, Hospital Ramón y Cajal, (b) CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain

  • Víctor Abraira

    (a) Unidad de Bioestadística, Hospital Ramón y Cajal, (b) CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain

Contributions of authors

MSH conceived of the idea for the review and wrote the protocol with input from DRB. EC designed the search strategy and JZ and VA devised the analysis strategy.

Declarations of interest

We have no competing interests to declare. This article presents an extension to a systematic review undertaken as part of the 2011 NICE guideline on ‘The Diagnosis and Treatment of Lung Cancer (update)’ (NICE 2011). 

Acknowledgements

We would like to thank the National Institute for Health and Clinical Excellence (NICE), the National Collaborating Centre for Cancer and the Guideline Development Group for the ‘Diagnosis and Treatment of Lung Cancer (update)’ NICE Guideline (2011).

Version history

Published

Title

Stage

Authors

Version

2014 Nov 13

PET‐CT for assessing mediastinal lymph node involvement in patients with suspected resectable non‐small cell lung cancer

Review

Mia Schmidt‐Hansen, David R Baldwin, Elise Hasler, Javier Zamora, Víctor Abraira, Marta Roqué i Figuls

https://doi.org/10.1002/14651858.CD009519.pub2

2011 Dec 07

PET‐CT for assessing mediastinal lymph node involvement in patients with suspected resectable non‐small cell lung cancer

Protocol

Mia Schmidt‐Hansen, David R Baldwin, Elise Collins, Javier Zamora, Víctor Abraira

https://doi.org/10.1002/14651858.CD009519

Keywords

MeSH

Table 1. Search strategy for OVID MEDLINE database (and adapted for other databases)

1

 exp Lung Neoplasms/

2

((lung or lungs or pulmonary) adj3 (neoplasm$ or cancer$ or carcinoma$ or adenocarcinoma$ or angiosarcoma$ or chrondosarcoma$ or sarcoma$ or teratoma$ or lymphoma$ or blastoma$ or microcytic$ or tumour$ or tumor$)).ti,ab.

3

NSCLC.ti,ab.

4

or/1‐3

5

Tomography/

6

Tomography, Emission‐Computed/   

7

Positron‐Emission Tomography/

8

Tomography, Spiral Computed/

9

Fludeoxyglucose f 18/

10

FDG or Fludeoxyglucose or fluorodeoxyglucose or depreotide).tw.

11

((positron or photon or scintillation) adj3 (emission or tomograph$)).tw.

12

(CGC or PET or SPECT or NEOTECT or NEOSPECT or NEOTEC).tw.

13

or/5‐12

14

4 and 13

15

Neoplasm Staging/

16

(staging or grading).tw.

17

Lymphatic Metastasis/

18

Neoplasm Invasiveness/

19

Neoplasm Metastasis/

20

Mediastinal Neoplasms/

21

Lymph Nodes/

22

Mediastinum/

23

((lymph node or mediastin$) adj2 (malignan$ or metast$ or neoplasm$)).tw.

24

or/15‐23

25

14 and 24

Figures and Tables -
Table 1. Search strategy for OVID MEDLINE database (and adapted for other databases)
Table 2. Study details

Study ID

First author, year of publication

Clinical features and settings

Inclusion and exclusion criteria, previous tests for lung cancer (diagnosis and staging), clinical setting

Participants

Sample size, age, sex, comorbidities, country, histology of primary tumour

Study design

Prospective/retrospective, case‐control/consecutive/random patient series

Reference standard(s)

The reference standard(s) used

Index test

Details of the index test used including the type of PET‐CT scanner, FDG dose, injection‐to‐scan time, attenuation correction and the cut‐off values for test positivity (malignancy)

Follow‐up

All patients accounted for in results, missing/uninterpretable test results, reasons for withdrawal, adverse events caused by test

Notes

Source of funding, anything else of relevance

FDG: [18F]‐2‐fluoro‐deoxy‐D‐glucose
PET‐CT: positron emission tomography and computed tomography

Figures and Tables -
Table 2. Study details
Table 3. Study characteristics

Item

Description

Was the spectrum of patients representative of the spectrum of patients who will receive the test in practice?

'Yes' if the characteristics of the participants are well described and probably typical of a secondary healthcare setting
'No' if the sample is unrepresentative of people with potentially resectable lung cancer in general
'Unclear' if the source or characteristics of participants is not adequately described

Is the reference standard likely to correctly identify the target condition?

'Yes' if reference standard is sampling of mediastinal nodes with pathological diagnosis
'No' if there is no sampling of mediastinal nodes with pathological diagnosis

'Unclear' if insufficient information is provided

Is the time period between the reference standard and the index test short enough to be reasonably sure that the target condition did not change between the two tests?

'Yes' if the time period between PET‐CT and the reference standard is ≤ 8 weeks
'No' if the time period between PET‐CT and the reference standard is > 8 weeks

'Unclear' if insufficient information is provided

Partial verification avoided?

'Yes' if all participants who received the index text also underwent the reference test
'No' if not all the participants who received the index test also underwent the reference test
'Unclear' if insufficient information is provided
If not all participants received the reference tests, how many did not (of the total)?

Differential verification avoided?

'Yes' if the same reference test was used regardless of the index test results
'No' if different reference tests are used depending on the results of the index test
'Unclear' if insufficient information is provided
If any participants received a different reference test, what were the reasons stated for this, and how many participants were involved?

Incorporation avoided?

Should be ‘Yes' for all studies, as the reference standard is defined in the inclusion criteria as pathological staging

'Yes' if the index test if not part of the reference standard

'No' if the index test if clearly part of the reference standard

'Unclear' if insufficient information is provided to assess this item

Reference standard results blinded?

'Yes' if the report stated that the person undertaking the reference test did not know the results of the index tests, or if the two tests were carried out in different places
'No' if the report stated that the same person performed both tests, or that the results of the index tests were known to the person undertaking the reference tests
'Unclear' if insufficient information provided

Index test results blinded?

'Yes' if the report stated that the person undertaking the index test did not know the results of the reference tests, or if the two tests were carried out in different places
'No' if the report stated that the same person performed both tests, or that the results of the index tests were known to the person undertaking the reference tests
'Unclear' if insufficient information provided

Relevant clinical data available?

'Yes' if clinical data (i.e. patient history, other test results) that would normally be available when the test results are interpreted and similar data are available in the study
'No' if the clinical data (i.e. patient history, other test results) that would normally be available when the test results are interpreted are not available in the study or if other test results are available that would not normally be available when interpreting the test results
'Unclear' if the paper does not explain which clinical information was available at the time of assessment

Uninterpretable results reported?

'Yes' if the number of participants in the two‐by‐two table matches the number of participants recruited into the study, or if sufficient explanation is provided for any discrepancy
'No' if the number of participants in the two‐by‐two table does not match the number of participants recruited into the study, and insufficient explanation is provided for any discrepancy
'Unclear' if insufficient information is given to permit judgement
Report how many results were uninterpretable (of the total)

Withdrawals explained?

'Yes' if there are no participants excluded from the analysis, or if exclusions are adequately described
'No' if there are participants excluded from the analysis and there is no explanation given
'Unclear' if not enough information is given to assess whether any participants were excluded from the analysis
Report how many participants were excluded from the analysis, for reasons other than uninterpretable results

If a cut‐off value has been used, was it established before the study was started (pre‐specified cut‐off value)?

'Yes' if pre‐specified
'No' if the authors selected the optimal cut‐off value based on the results of the study
'Unclear' if there is a range of cut‐off values and there is doubt which cut‐off has been used, or if there is no mention at all of a cut‐off value

Did the study provide a clear definition of what was considered to be a positive result?

'Yes' if the definition of a positive result is clearly stated (e.g. SUV)
'No' if no definition of what was considered a positive result is stated or the definition of a positive result varied between the patients
'Unclear' if not enough information is given to permit judgement

Was the study free of commercial funding?

'Yes' if the funding source is clearly stated and is not commercial
'No' if the funding source is clearly stated and is commercial
'Unclear' if not enough information is given to assess whether the funding source is commercial

SUV: standard uptake values

Figures and Tables -
Table 3. Study characteristics