Huebner R H, Park K C, Shepherd J E, Schwimmer J, Czernin J, Phelps M E, Gambhir S S
Crump Institute for Biological Imaging, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, School of Medicine, 90095-1770, USA.
J Nucl Med. 2000 Jul;41(7):1177-89.
A meta-analysis of the literature for the use of FDG PET in the detection of recurrent colorectal cancer (CRC) was conducted to evaluate the quality of the reported studies. Overall values for the sensitivity and specificity of whole-body FDG PET and an overall FDG PET-directed percentage change in management were also determined through this analysis.
Guidelines to evaluate the articles were formulated on the basis of the U.S. medical payer source criteria for assessing studies that report information on usage of new medical technology. A metaanalysis was conducted using methodology described in the peer-reviewed literature.
On the basis of the guidelines established for our review, the availability of necessary information for assessing the reliability of the FDG PET data for diagnosing recurrent CRC was less than ideal. Through a meta-analysis of 11 articles, we determined, within a 95% confidence level, an overall sensitivity of 97% (95% confidence level, 95%-99%) and an overall specificity of 76% (95% confidence level, 64%-88%) for FDG PET detecting recurrent CRC throughout the whole body. Furthermore, through pooling of the change-in-management data, an overall FDG PET-directed change in management was calculated to be 29% (95% confidence level, 25%-34%).
Our review suggests that improvements can be made to more effectively report the results of these FDG PET studies. The overall values determined through the meta-analysis indicate the potential benefits of using FDG PET as a diagnostic or management tool. Furthermore, these values should prove to be useful to assess the cost-effectiveness of using FDG PET in the management of patients with recurrent CRC.
对使用氟代脱氧葡萄糖正电子发射断层扫描（FDG PET）检测复发性结直肠癌（CRC）的文献进行了荟萃分析，以评估所报道研究的质量。通过该分析还确定了全身FDG PET的敏感性和特异性的总体值以及基于FDG PET的管理总体百分比变化。
根据美国医疗支付方评估报告新医疗技术使用信息的研究的标准，制定了评估文章的指南。使用同行评审文献中描述的方法进行荟萃分析。
根据我们综述所确立的指南，评估FDG PET诊断复发性CRC数据可靠性所需信息的可用性不太理想。通过对11篇文章的荟萃分析，我们在95%置信水平下确定，FDG PET检测全身复发性CRC的总体敏感性为97%（95%置信水平，95%-99%），总体特异性为76%（95%置信水平，64%-88%）。此外，通过汇总管理变化数据，计算得出基于FDG PET的管理总体变化为29%（95%置信水平，25%-34%）。
我们的综述表明，可以进行改进以更有效地报告这些FDG PET研究的结果。通过荟萃分析确定的总体值表明了使用FDG PET作为诊断或管理工具的潜在益处。此外，这些值应有助于评估在复发性CRC患者管理中使用FDG PET的成本效益。
