Weng Wan-Wen, Dong Meng-Jie, Zhang Jun, Yang Jun, Xu Qin, Zhu Yang-Jun, Liu Ning-Hu
Department of Nuclear Medicine, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China E-mail :
Asian Pac J Cancer Prev. 2014;15(22):9879-84. doi: 10.7314/apjcp.2014.15.22.9879.
The purpose of the current study was to conduct a systematic review of the published literature to evaluate the diagnostic accuracy of FDG-PET, PTE/CT, MRI and scintigraphy for multiple myeloma related bone disease.
Through a search of PubMed, EMBASE, and the Cochrane Library, two reviewers independently assessed the methodological quality of each study. We estimated pooled sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), and two sample Z-tests were conducted to evaluate for differences in sensitivity, specificity, area under the curve (AUC), and the Q* index between any two diagnostic modalities.
A total of 17 studies were reviewed. The MRI had a pooled sensitivity of 0.88, specificity of 0.68, AUC of 0.897, and Qindex of 0.828, whereas for MIBI, the corresponding values were 0.98, 0.90, 0.991, and 0.962, respectively, and for bone scan, they were 066, 0.83, 0.805, and 0.740, respectively. The corresponding values of MIBI were 0.98, 0.90, 0.991, and 0.962, respectively. For PET and PET/CT, the values were 0.91, 0.69, 0.927 and 0.861, respectively. Statistically significant differences were not found in the sensitivity, specificity, AUC, and Q index between MRI, scintigraphy, FDG-PET and PET/CT.
On the condition that X ray is taken as a reference in our study, we suggested that FDG-PET, PTE/CT, MRI and scintigraphy are all associated with high detection rate of bone disease in patients with MM. Thus, in clinical practice, it is recommended that we could choose these tests according to the condition of the patient.
本研究旨在对已发表的文献进行系统评价，以评估氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）、正电子发射断层扫描/计算机断层扫描（PTE/CT）、磁共振成像（MRI）和闪烁扫描术对多发性骨髓瘤相关骨病的诊断准确性。
通过检索PubMed、EMBASE和Cochrane图书馆，两名评价者独立评估每项研究的方法学质量。我们估计了合并敏感度、特异度、阳性和阴性似然比（PLR和NLR），并进行了两个样本Z检验，以评估任意两种诊断方法在敏感度、特异度、曲线下面积（AUC）和Q*指数方面的差异。
共纳入17项研究。MRI的合并敏感度为0.88，特异度为0.68，AUC为0.897，Q指数为0.828；而对于甲氧基异丁基异腈（MIBI），相应的值分别为0.98、0.90、0.991和0.962；对于骨扫描，相应的值分别为0.66、0.83、0.805和0.740。MIBI的相应值分别为0.98、0.90、0.991和0.962。对于PET和PET/CT，相应的值分别为0.91、0.69、0.927和0.861。在MRI、闪烁扫描术、FDG-PET和PET/CT之间，敏感度、特异度、AUC和Q指数未发现统计学显著差异。
在本研究以X线为参照的情况下，我们建议FDG-PET、PTE/CT、MRI和闪烁扫描术对骨髓瘤患者骨病均有较高的检出率。因此，在临床实践中，建议根据患者情况选择这些检查。
