Seminars in nuclear medicine
June 10, 2026 · via Europe PMC
The diagnostic performance and clinical value of [18F]FDG PET/CT in pleural mesothelioma - A systematic review and meta-analysis.
Thostrup AH, Stubbe NU, Schreiner MP, Bentestuen M, Olesen AV, Zacho HD
AI summary — for doctors, generated from the abstract only
FDG PET/CT is highly sensitive and reasonably specific for diagnosing pleural mesothelioma.
What was studied
Systematic review and meta-analysis of 41 studies (10 in the pooled diagnostic analysis) of FDG PET/CT in treatment-naive patients against histopathology, plus secondary aims on nodal and distant staging.
Key findings
- Pooled sensitivity was 0.94 (95% CI 0.87-0.97) and specificity 0.84 (95% CI 0.73-0.91) versus benign pleural lesions.
- Substantial heterogeneity was present but no publication bias was detected.
Clinical relevance
PET/CT helps distinguish mesothelioma from benign pleural disease, though false positives remain.
Who should care
Limitations
Substantial heterogeneity between studies, and only 10 studies contributed to the pooled accuracy.
Use FDG PET/CT as a useful adjunct but do not rely on it alone; biopsy remains necessary.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
PURPOSE
This systematic review and meta-analysis aims to evaluate the diagnostic accuracy of FDG PET/CT for diagnosing pleural mesothelioma in treatment-naïve patients using histopathology as reference standard. Secondary aims include evaluation of FDG PET/CT or FDG PET/MRI's diagnostic accuracy of lymph node and distant metastases, their impact on TNM-staging, and PET uptake and volumetric parameters in pleural mesothelioma.
METHODS
We conducted a systematic review and meta-analysis adhering to 'Preferred Reporting Guidelines for Systematic reviews and Meta-Analyses' (PRISMA) with a predefined literature search. It consisted of the terms: "pleura" or "pleural" or "mesothelioma", "PET" or "positron emission tomography", and "FDG" or "fluorodeoxyglucose". Two independent reviewers systematically screened the literature based on eligibility criteria, extracted data, and evaluated quality of evidence. The meta-analysis was performed using a hierarchical model to estimate pooled diagnostic accuracy parameters. Publication bias was assessed with Deeks' regression test.
RESULTS
Forty-one studies were included; the primary aim was evaluated by a meta-analysis which included 10 studies. Thirty-eight studies were included for evaluating secondary aims. The estimated pooled sensitivity and specificity for FDG PET/CT in differentiating pleural mesothelioma from benign pleural lesions were 0.94 (95%CI: 0.87-0.97) and 0.84 (95%CI: 0.73-0.91), respectively. There was substantial study heterogeneity, but no publication bias was detected.
CONCLUSION
This study shows high sensitivity and specificity of FDG PET/CT for diagnosing pleural mesothelioma. The results are compatible with previous findings and give an updated evidence base to compare diagnostic performance of FDG PET/CT to other imaging modalities e.g. contrast-enhanced CT or PET with novel tracers.
DOI
10.1053/j.semnuclmed.2026.05.010
PMID
42270474
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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