Zhang Jun, Li Lin-Fa, Zhu Yang-Jun, Qiu Hong, Xu Qin, Yang Jun, Weng Wan-Wen, Liu Ning-Hu
aDepartment of Nuclear Medicine bGeneral Intensive Care Unit, The First Affiliated Hospital, Zhejiang University, Zhejiang, People's Republic of China.
Nucl Med Commun. 2014 Dec;35(12):1233-46. doi: 10.1097/MNM.0000000000000202.
The aim of this study was to evaluate the diagnostic performance of fluorine-18 fluorodeoxyglucose-PET (F-FDG-PET), leukocyte scintigraphy (LS), and monoclonal antigranulocyte antibody scintigraphy (MAAS) in patients with inflammatory bowel disease (IBD) and perform pairwise comparisons of the diagnostic accuracy between these different imaging modalities.
Through a search of PubMed, EMBASE, and the Cochrane Library (January 1993-May 2013), we performed a random effects meta-analysis and constructed summary receiver operating characteristic curves on per-bowel-segment or per-patient basis. Two-sample Z-tests were performed to evaluate differences in sensitivity, specificity, area under the curve (AUC), and the Q* index between any two diagnostic modalities on per-bowel-segment basis.
Twenty prospective studies were reviewed. On per-bowel-segment basis, the F-FDG-PET had a pooled sensitivity of 0.84, specificity of 0.86, AUC of 0.913, and Q* index of 0.845, whereas for LS, the corresponding values were 0.79, 0.86, 0.877, and 0.808, respectively, and for MAAS they were 0.45, 0.94, 0.524, and 0.518, respectively. On per-patient basis, the corresponding values of LS were 0.91, 0.85, 0.937, and 0.874, respectively. Statistically significant differences were not found in the sensitivity, specificity, AUC, and Q* index between F-FDG-PET and LS on per-bowel-segment basis.
F-FDG-PET has a high degree of diagnostic performance compared with LS and MAAS on per-bowel-segment basis in patients with IBD. LS may be used with satisfactory diagnostic accuracy in detecting active IBD when PET systems are unavailable. A larger prospective validation of these findings would be valuable.
本研究旨在评估氟-18氟脱氧葡萄糖正电子发射断层扫描（F-FDG-PET）、白细胞闪烁显像（LS）和单克隆抗粒细胞抗体闪烁显像（MAAS）在炎症性肠病（IBD）患者中的诊断性能，并对这些不同成像方式之间的诊断准确性进行两两比较。
通过检索PubMed、EMBASE和Cochrane图书馆（1993年1月至2013年5月），我们进行了随机效应荟萃分析，并在每个肠段或每位患者的基础上构建了汇总的受试者工作特征曲线。进行双样本Z检验以评估在每个肠段基础上任意两种诊断方式之间在敏感性、特异性、曲线下面积（AUC）和Q*指数方面的差异。
回顾了20项前瞻性研究。在每个肠段基础上，F-FDG-PET的合并敏感性为0.84，特异性为0.86，AUC为0.913，Q指数为0.845；而对于LS，相应的值分别为0.79、0.86、0.877和0.808；对于MAAS，它们分别为0.45、0.94、0.524和0.518。在每位患者基础上，LS的相应值分别为0.91、0.85、0.937和0.874。在每个肠段基础上，F-FDG-PET和LS之间在敏感性、特异性、AUC和Q指数方面未发现统计学上的显著差异。
在IBD患者中，在每个肠段基础上，F-FDG-PET与LS和MAAS相比具有较高的诊断性能。当无法使用PET系统时，LS在检测活动性IBD方面可能具有令人满意的诊断准确性。对这些发现进行更大规模的前瞻性验证将是有价值的。
