{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T16:16:45Z","timestamp":1785860205676,"version":"3.56.0"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100009104","name":"Department of Health Research, India","doi-asserted-by":"publisher","award":["File No. EM-Del\/Centreforguidelines\/DHR\/2024"],"award-info":[{"award-number":["File No. EM-Del\/Centreforguidelines\/DHR\/2024"]}],"id":[{"id":"10.13039\/501100009104","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is uncertainty regarding the optimal next imaging modality for identifying likely malignant pulmonary lesions in patients with abnormal chest radiography, with or without respiratory symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We compared the diagnostic accuracy of chest contrast-enhanced computed tomography (CECT) and positron emission tomography or positron emission tomography-computed tomography (PET\/PET-CT) for identifying malignant pulmonary lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources and methods:<\/jats:title>\n                    <jats:p>We searched the PubMed, Embase, Scopus, and Cochrane CENTRAL databases to identify head-to-head diagnostic accuracy studies comparing CECT and PET\/PET-CT for their ability to differentiate between benign and malignant pulmonary lesions. The risk of bias of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies \u2013 Comparative (QUADAS-C) tool. Meta-analysis was performed using the bivariate random effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We included eight studies, comprising a total of 873 subjects. The pooled sensitivity and specificity of CECT (850 lesions) were 0.93 (95% CI, 0.89\u20130.96;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200924.99%) and 0.54 (95% CI, 0.32\u20130.75;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200984.00%). The pooled sensitivity and specificity of PET\/PET-CT (851 lesions) were 0.87 (95% CI, 0.78\u20130.93;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200965.15%) and 0.83 (95% CI, 0.63\u20130.94;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200973.23%). Compared to CECT, PET\/PET-CT had a lower relative sensitivity (relative ratio [RR], 0.93; 95% CI, 0.89\u20130.97;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and a higher relative specificity (RR, 1.69; 95% CI, 1.18\u20132.41;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01). After excluding the study with the largest sample size, PET\/PET-CT was not less sensitive than CECT (RR, 0.99; 95% CI, 0.94\u20131.04;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.73). There was a high\/unclear risk of bias and applicability concerns in the population domain in six out of eight studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Based on limited evidence with applicability concerns, CECT of the chest may have a higher sensitivity but lower specificity than PET\/PET-CT for identifying malignant lesions among patients with suspected lung cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>The protocol for the systematic review was prospectively registered on PROSPERO (CRD42024590904)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666251395432","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T09:54:00Z","timestamp":1764150840000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Contrast-enhanced computed tomography versus positron emission tomography\/positron emission tomography-computed tomography in suspected lung cancer: a systematic review and meta-analysis of diagnostic accuracy studies"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2010-4651","authenticated-orcid":false,"given":"Tejas Menon","family":"Suri","sequence":"first","affiliation":[{"name":"Department of Pulmonary, Critical Care &amp; Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayush","family":"Goel","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Critical Care &amp; Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maroof Ahmad","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawan","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Critical Care &amp; Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Critical Care &amp; Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Hadda","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Critical Care &amp; Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karan","family":"Madan","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Critical Care &amp; Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anant","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Critical Care &amp; Sleep Medicine, All India Institute of Medical Sciences, New Delhi 110029, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_3_4_3_2","unstructured":"SEER*Explorer: An interactive website for SEER cancer statistics [Internet] https:\/\/seer.cancer.gov\/statistics-network\/explorer\/ (2025 accessed 14 June 2025)."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.4103\/lungindia.lungindia_144_22"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01694-4"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr.2019.03.03"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr.2018.05.02"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.08.854"},{"key":"e_1_3_4_9_2","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al. 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