Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
AJR Am J Roentgenol. 2013 Jun;200(6):W654-60. doi: 10.2214/AJR.12.9168.
Several studies have assessed PET to complement the anatomic information obtained from other imaging modalities in various clinical contexts for the management of glioma. We constructed an evidence map of clinical evidence on the use of PET in glioma and identified research gaps.
We searched PubMed and Scopus (from inception through June 30, 2011) to identify studies assessing the use of PET for glioma regardless of setting of care or indication. We extracted test objectives, study characteristics, and phases of diagnostic evidence and then assessed research diversity and temporal trends in the literature. We excluded studies assessing only technical feasibility and optimization of PET.
A total of 129 studies were considered eligible; the number of articles published annually has greatly increased over time (p for trend < 0.001). Most studies (n = 118, 91%) assessed diagnostic or prognostic performance; fewer studies reported on the impact of PET on diagnostic thinking (n = 4, 3%), therapeutic decisions (n = 4, 3%), or patient-relevant clinical outcomes (n = 3; 2%). Fluorine-18 FDG (n = 73, 57%) or (11)C-methionine (n = 44, 34%) were the two most commonly evaluated PET tracers. Pretherapy assessment (n = 72, 56%) and monitoring of treatment response (n = 48, 37%) were the most common settings of test use assessed in the research studies.
More primary studies, particularly studies of newer tracers focusing on biopsy or treatment planning, are needed to better characterize the role of PET in specific contexts.
多项研究已经评估了 PET 在不同临床环境下与其他成像模式相结合，对胶质瘤进行管理的作用。我们构建了一张胶质瘤中使用 PET 的临床证据图谱，并确定了研究空白。
我们检索了 PubMed 和 Scopus（从建库到 2011 年 6 月 30 日），以确定评估无论治疗环境或适应证如何使用 PET 的研究。我们提取了检测目标、研究特征和诊断证据阶段，然后评估了文献中的研究多样性和时间趋势。我们排除了仅评估 PET 技术可行性和优化的研究。
共有 129 项研究被认为符合条件；发表的文章数量逐年大幅增加（趋势 p < 0.001）。大多数研究（n = 118，91%）评估了诊断或预后性能；较少的研究报告了 PET 对诊断思维（n = 4，3%）、治疗决策（n = 4，3%）或患者相关临床结局（n = 3，2%）的影响。氟-18 氟脱氧葡萄糖（n = 73，57%）或碳-11 蛋氨酸（n = 44，34%）是最常评估的两种 PET 示踪剂。治疗前评估（n = 72，56%）和治疗反应监测（n = 48，37%）是研究中评估的最常见检测使用情况。
需要更多的原始研究，特别是关注活检或治疗计划的新型示踪剂的研究，以更好地确定 PET 在特定情况下的作用。
