Department of Nuclear Medicine, Oncology Institute of Southern Switzerland, via Ospedale 12, 6500, Bellinzona, Switzerland.
Endocrine. 2013 Aug;44(1):70-8. doi: 10.1007/s12020-013-9932-z. Epub 2013 Mar 26.
Several studies have investigated the diagnostic performance of (99m)Tc-MIBI scan in the evaluation of thyroid nodules suspicious for malignancy with conflicting results. The aim of our study is to meta-analyze published data on this topic. A comprehensive literature search of studies published through December 2012 regarding the diagnostic performance of (99m)Tc-MIBI scan in the evaluation of thyroid nodules suspicious for malignancy was carried out. Pooled sensitivity and specificity of (99m)Tc-MIBI scan on a per lesion-based analysis and the area under the ROC curve were calculated. Pathological reports of thyroid nodules were considered as reference standard. Twenty-one studies were included in the meta-analysis. Pooled sensitivity and specificity of (99m)Tc-MIBI scan in detecting malignant thyroid nodules were 85.1 % [95 % confidence interval (95 % CI): 81.1-88.5 %] and 45.7 % (95 % CI: 42.7-48.7 %), respectively, on a per lesion-based analysis, irrespective of eventual results of previous technetium pertechnetate ((99m)TcO4) or iodine-123 ((123)I) scan. The area under the ROC curve was 0.78. A sub-analysis restricted to data on hypofunctioning nodules on (99m)TcO4 or (123)I scans was performed: pooled sensitivity and specificity of (99m)Tc-MIBI scan in these nodules were 82.1 % (95 % CI: 77.2-86.3 %) and 62.8 % (95 % CI: 58.9-66.7 %), respectively, on a per lesion-based analysis. The area under the ROC curve was 0.81. (99m)Tc-MIBI scan is a sensitive diagnostic tool in predicting the malignancy of thyroid nodules. Therefore, this imaging method could be helpful in patients with thyroid nodules in which malignancy is suspected on the basis of conventional diagnostic techniques. Higher specificity can be reached when hypofunctioning thyroid nodules are considered.
几项研究调查了 (99m)Tc-MIBI 扫描在评估疑似恶性甲状腺结节中的诊断性能，结果存在争议。我们的研究目的是对该主题的已发表数据进行荟萃分析。通过对截至 2012 年 12 月发表的关于 (99m)Tc-MIBI 扫描在评估疑似恶性甲状腺结节中的诊断性能的研究进行全面的文献检索。基于病变的分析计算了 (99m)Tc-MIBI 扫描的汇总敏感性和特异性以及 ROC 曲线下面积。甲状腺结节的病理报告被认为是参考标准。21 项研究被纳入荟萃分析。基于病变的分析，(99m)Tc-MIBI 扫描在检测恶性甲状腺结节方面的汇总敏感性和特异性分别为 85.1%[95%置信区间(95%CI)：81.1-88.5%]和 45.7%(95%CI：42.7-48.7%)，无论先前锝 99 高锝酸盐((99m)TcO4)或碘 123((123)I)扫描的最终结果如何。ROC 曲线下面积为 0.78。进行了一项仅限于 (99m)TcO4 或 (123)I 扫描功能低下结节数据的亚分析：在这些结节中，(99m)Tc-MIBI 扫描的汇总敏感性和特异性分别为 82.1%(95%CI：77.2-86.3%)和 62.8%(95%CI：58.9-66.7%)，基于病变的分析。ROC 曲线下面积为 0.81。(99m)Tc-MIBI 扫描是预测甲状腺结节恶性的一种敏感诊断工具。因此，这种成像方法在根据常规诊断技术怀疑甲状腺结节恶性时可能会有所帮助。当考虑功能低下的甲状腺结节时，可以达到更高的特异性。
