Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
Eur J Radiol. 2012 Feb;81(2):303-11. doi: 10.1016/j.ejrad.2010.11.020. Epub 2010 Dec 9.
Evaluation of bone marrow infiltration is an essential step in the staging of lymphoma. The accuracy of (18)F-fluorodeoxyglucose-positron emission tomography ((18)F-FDG PET), combined (18)F-fluorodeoxyglucose-positron emission tomography/computed tomography ((18)F-FDG-PET/CT) and magnetic resonance imaging (MRI) in diagnosing bone marrow involvement of lymphoma has never been systematically assessed, and the present systematic review was aimed at this issue.
MEDLINE, EMBASE, Cochrane library and some other databases, from January 1995 to July 2010, were searched for initial studies. All the studies published in English or Chinese relating to the diagnostic value of (18)F-FDG PET, PET/CT and MRI for patients with bone marrow involvement of lymphoma were collected. We extracted data to calculate sensitivity, specificity, SROC curves and AUC and to test for heterogeneity. The statistic software called "Meta-Disc 1.4" was used for data analysis.
In 32 included studies, PET/CT had the highest pooled sensitivity, 91.6% (95%CI: 85.1, 95.9) and highest pooled specificity, 90.3% (95%CI: 85.9, 93.7). PET/CT also had the highest pooled DOR, 68.89 (95%CI: 15.88, 298.92). The AUC of PET, PET/CT, and MRI were 0.9430, 0.9505 and 0.8764. There was heterogeneity among studies and no evidence of publication bias.
PET/CT was a highly sensitive and specific modality in diagnosing patients with bone marrow involvement in lymphoma. Compared with MRI and PET alone, PET/CT can play important roles in the staging of lymphoma.
评估骨髓浸润是淋巴瘤分期的重要步骤。（18）F-氟脱氧葡萄糖正电子发射断层扫描（（18）F-FDG PET）、（18）F-FDG 正电子发射断层扫描/计算机断层扫描（（18）F-FDG-PET/CT）和磁共振成像（MRI）联合诊断淋巴瘤骨髓受累的准确性尚未得到系统评估，本系统评价旨在解决这一问题。
从 1995 年 1 月至 2010 年 7 月，检索 MEDLINE、EMBASE、Cochrane 图书馆和其他一些数据库，以获取初始研究。收集了所有发表的关于（18）F-FDG PET、PET/CT 和 MRI 对淋巴瘤骨髓受累患者诊断价值的中英文研究。我们提取数据来计算敏感性、特异性、SROC 曲线和 AUC，并检验异质性。使用名为“Meta-Disc 1.4”的统计软件进行数据分析。
在 32 项纳入的研究中，PET/CT 的合并敏感性最高，为 91.6%（95%CI：85.1，95.9），特异性最高，为 90.3%（95%CI：85.9，93.7）。PET/CT 的合并 DOR 最高，为 68.89（95%CI：15.88，298.92）。PET、PET/CT 和 MRI 的 AUC 分别为 0.9430、0.9505 和 0.8764。研究之间存在异质性，无发表偏倚的证据。
PET/CT 是诊断淋巴瘤骨髓受累患者的一种高度敏感和特异的方法。与 MRI 和 PET 相比，PET/CT 在淋巴瘤分期中具有重要作用。
