Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
Clin Breast Cancer. 2013 Aug;13(4):271-9. doi: 10.1016/j.clbc.2013.02.003. Epub 2013 May 25.
To evaluate the diagnostic performance of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in monitoring the response of breast cancers to neoadjuvant chemotherapy.
Articles published in medical and oncologic journals between January 2000 and June 2012 were identified by systematic MEDLINE, Cochrane Database for Systematic Reviews, and EMBASE, and by manual searches of the references listed in original and review articles. Quality of the included studies was assessed by using the quality assessment of diagnosis accuracy studies score tool. Meta-DiSc statistical software was used to calculate the summary sensitivity and specificity, positive predictive and negative predictive values, and the summary receiver operating characteristics curve (SROC).
Fifteen studies with 745 patients were included in the study after meeting the inclusion criteria. The pooled sensitivity and specificity of FDG-PET or PET/CT were 80.5% (95% CI, 75.9%-84.5%) and 78.8% (95% CI, 74.1%-83.0%), respectively, and the positive predictive and negative predictive values were 79.8% and 79.5%, respectively. After 1 and 2 courses of chemotherapy, the pooled sensitivity and false-positive rate were 78.2% (95% CI, 73.8%-82.5%) and 11.2%, respectively; and 82.4% (95% CI, 77.4%-86.1%) and 19.3%, respectively.
Analysis of the findings suggests that FDG-PET has moderately high sensitivity and specificity in early detection of responders from nonresponders, and can be applied in the evaluation of breast cancer response to neoadjuvant chemotherapy in patients with breast cancer.
评估氟-18 氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）在监测乳腺癌对新辅助化疗反应中的诊断性能。
通过系统地搜索 MEDLINE、Cochrane 系统评价数据库和 EMBASE，以及手动搜索原始和综述文章中列出的参考文献，确定了 2000 年 1 月至 2012 年 6 月期间发表在医学和肿瘤学期刊上的文章。使用诊断准确性研究质量评估评分工具评估纳入研究的质量。使用 Meta-DiSc 统计软件计算汇总敏感性和特异性、阳性预测值和阴性预测值以及汇总受试者工作特征曲线（SROC）。
在满足纳入标准后，共有 15 项研究、745 例患者纳入本研究。FDG-PET 或 PET/CT 的汇总敏感性和特异性分别为 80.5%（95%置信区间，75.9%-84.5%）和 78.8%（95%置信区间，74.1%-83.0%），阳性预测值和阴性预测值分别为 79.8%和 79.5%。在化疗 1 个和 2 个疗程后，汇总敏感性和假阳性率分别为 78.2%（95%置信区间，73.8%-82.5%）和 11.2%；82.4%（95%置信区间，77.4%-86.1%）和 19.3%。
分析结果表明，FDG-PET 在早期检测无反应者中的反应者方面具有中等的敏感性和特异性，可用于评估乳腺癌患者对新辅助化疗的反应。
