Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy.
Eur J Nucl Med Mol Imaging. 2012 Jul;39(7):1144-53. doi: 10.1007/s00259-012-2087-y. Epub 2012 Feb 23.
The aim of this study was to systematically review and conduct a meta-analysis of published data about the diagnostic performance of (18)F-dihydroxyphenylalanine (DOPA) positron emission tomography (PET) in patients with paraganglioma (PG).
A comprehensive computer literature search of studies published through 30 June 2011 regarding (18)F-DOPA PET or PET/computed tomography (PET/CT) in patients with PG was performed in PubMed/MEDLINE, Embase and Scopus databases. Pooled sensitivity and specificity of (18)F-DOPA PET or PET/CT in patients with PG on a per patient- and on a per lesion-based analysis were calculated. The area under the receiver-operating characteristic (ROC) curve was calculated to measure the accuracy of (18)F-DOPA PET or PET/CT in patients with PG. Furthermore, a sub-analysis taking into account the different genetic mutations in PG patients was also performed.
Eleven studies comprising 275 patients with suspected PG were included in this meta-analysis. The pooled sensitivity of (18)F-DOPA PET and PET/CT in detecting PG was 91% [95% confidence interval (CI) 87-94%] on a per patient-based analysis and 79% (95% CI 76-81%) on a per lesion-based analysis. The pooled specificity of (18)F-DOPA PET and PET/CT in detecting PG was 95% (95% CI 86-99%) on a per patient-based analysis and 95% (95% CI 84-99%) on a per lesion-based analysis. The area under the ROC curve was 0.95 on a per patient- and 0.94 on a per lesion-based analysis. Heterogeneity between the studies about sensitivity of (18)F-DOPA PET or PET/CT was found. A significant increase in sensitivity of (18)F-DOPA PET or PET/CT was observed when a sub-analysis excluding patients with succinate dehydrogenase subunit B (SDHB) gene mutations was performed.
In patients with suspected PG (18)F-DOPA PET or PET/CT demonstrated high sensitivity and specificity. (18)F-DOPA PET or PET/CT are accurate methods in this setting. Nevertheless, possible sources of false-negative results should be kept in mind. Furthermore, SDHB gene mutations could influence (18)F-DOPA PET or PET/CT diagnostic performance.
本研究旨在系统性回顾并进行荟萃分析,评估氟代二羟苯丙氨酸(18F-DOPA)正电子发射断层扫描(PET)在副神经节瘤(PG)患者中的诊断性能。
通过对 PubMed/MEDLINE、Embase 和 Scopus 数据库进行全面的计算机文献检索,搜索截止至 2011 年 6 月 30 日有关 18F-DOPA PET 或 PG 患者 PET/CT 的研究。计算每位患者和每处病灶为基础的 18F-DOPA PET 或 PET/CT 在 PG 患者中的汇总敏感度和特异度。计算接收者操作特征(ROC)曲线下面积,以评估 18F-DOPA PET 或 PET/CT 在 PG 患者中的准确性。此外,还进行了考虑到 PG 患者不同基因突变的亚组分析。
本荟萃分析纳入了 11 项共 275 例疑似 PG 患者的研究。基于每位患者的分析,18F-DOPA PET 和 PET/CT 检测 PG 的汇总敏感度为 91%(95%置信区间[CI]87-94%),基于每处病灶的分析为 79%(95%CI 76-81%)。基于每位患者的分析,18F-DOPA PET 和 PET/CT 检测 PG 的汇总特异度为 95%(95%CI 86-99%),基于每处病灶的分析为 95%(95%CI 84-99%)。基于每位患者和每处病灶的 ROC 曲线下面积分别为 0.95 和 0.94。在关于 18F-DOPA PET 或 PET/CT 敏感度的研究之间存在异质性。当排除琥珀酸脱氢酶亚单位 B(SDHB)基因突变患者进行亚组分析时,观察到 18F-DOPA PET 或 PET/CT 敏感度显著增加。
在疑似 PG 患者中,18F-DOPA PET 或 PET/CT 显示出高敏感度和特异性。在该背景下,18F-DOPA PET 或 PET/CT 是准确的方法。然而,应该牢记可能导致假阴性结果的来源。此外,SDHB 基因突变可能影响 18F-DOPA PET 或 PET/CT 的诊断性能。