Dunet Vincent, Pomoni Anastasia, Hottinger Andreas, Nicod-Lalonde Marie, Prior John O
Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland (V.D.); Nuclear Medicine, Lausanne University Hospital, Lausanne, Switzerland (A.P., M.N.-L., J.O.P.); Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland (A.H.); Oncology, Lausanne University Hospital, Lausanne, Switzerland (A.H.).
Neuro Oncol. 2016 Mar;18(3):426-34. doi: 10.1093/neuonc/nov148. Epub 2015 Aug 4.
For the past decade (18)F-fluoro-ethyl-l-tyrosine (FET) and (18)F-fluoro-deoxy-glucose (FDG) positron emission tomography (PET) have been used for the assessment of patients with brain tumor. However, direct comparison studies reported only limited numbers of patients. Our purpose was to compare the diagnostic performance of FET and FDG-PET.
We examined studies published between January 1995 and January 2015 in the PubMed database. To be included the study should: (i) use FET and FDG-PET for the assessment of patients with isolated brain lesion and (ii) use histology as the gold standard. Analysis was performed on a per patient basis. Study quality was assessed with STARD and QUADAS criteria.
Five studies (119 patients) were included. For the diagnosis of brain tumor, FET-PET demonstrated a pooled sensitivity of 0.94 (95% CI: 0.79-0.98) and pooled specificity of 0.88 (95% CI: 0.37-0.99), with an area under the curve of 0.96 (95% CI: 0.94-0.97), a positive likelihood ratio (LR+) of 8.1 (95% CI: 0.8-80.6), and a negative likelihood ratio (LR-) of 0.07 (95% CI: 0.02-0.30), while FDG-PET demonstrated a sensitivity of 0.38 (95% CI: 0.27-0.50) and specificity of 0.86 (95% CI: 0.31-0.99), with an area under the curve of 0.40 (95% CI: 0.36-0.44), an LR+ of 2.7 (95% CI: 0.3-27.8), and an LR- of 0.72 (95% CI: 0.47-1.11). Target-to-background ratios of either FDG or FET, however, allow distinction between low- and high-grade gliomas (P > .11).
For brain tumor diagnosis, FET-PET performed much better than FDG and should be preferred when assessing a new isolated brain tumor. For glioma grading, however, both tracers showed similar performances.
在过去十年中，（18）F-氟乙基-L-酪氨酸（FET）和（18）F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）已被用于评估脑肿瘤患者。然而，直接比较研究报告的患者数量有限。我们的目的是比较FET和FDG-PET的诊断性能。
我们检索了1995年1月至2015年1月期间发表在PubMed数据库中的研究。纳入的研究应：（i）使用FET和FDG-PET评估孤立性脑病变患者；（ii）以组织学作为金标准。分析以每位患者为基础进行。研究质量根据STARD和QUADAS标准进行评估。
纳入了五项研究（119例患者）。对于脑肿瘤的诊断，FET-PET的汇总敏感性为0.94（95%CI：0.79-0.98），汇总特异性为0.88（95%CI：0.37-0.99），曲线下面积为0.96（95%CI：0.94-0.97），阳性似然比（LR+）为8.1（95%CI：0.8-80.6），阴性似然比（LR-）为0.07（95%CI：0.02-0.30），而FDG-PET的敏感性为0.38（95%CI：0.27-0.50），特异性为0.86（95%CI：0.31-0.99），曲线下面积为0.40（95%CI：0.36-0.44），LR+为2.7（95%CI：0.3-27.8），LR-为0.72（95%CI：0.47-1.11）。然而，FDG或FET的靶本比可区分低级别和高级别胶质瘤（P>.11）。
对于脑肿瘤诊断，FET-PET的表现远优于FDG，在评估新的孤立性脑肿瘤时应优先选用。然而，对于胶质瘤分级，两种示踪剂的表现相似。
