Ouyang Qiaohong, Duan Zhongxiang, Lei Jixiao, Jiao Guangli
Department of Nuclear Medicine, The First Affiliated Hospital of Chinese PLA General Hospital, No. 51 Fucheng Road, Beijing, 100048, China.
Tumour Biol. 2016 Mar;37(3):2999-3007. doi: 10.1007/s13277-015-4113-8. Epub 2015 Sep 29.
The early diagnosis of prostate cancer (PCa) appears to be of vital significance for the provision of appropriate treatment programs. Even though several sophisticated imaging techniques such as positron emission tomography/computed tomography (PET/CT) and elastosonography (ES) have already been developed for PCa diagnosis, the diagnostic accuracy of these imaging techniques is still controversial to some extent. Therefore, a comprehensive meta-analysis in this study was performed to compare the accuracy of various diagnostic imaging methods for PCa, including 11C-choline PET/CT, 11C-acetate PET/CT, 18F-fluorocholine PET/CT, 18F-fluoroglucose PET/CT, transrectal real-time elastosonography (TRTE), and shear-wave elastosonography (SWE). The eligible studies were identified through systematical searching for the literature in electronic databases including PubMed, Cochrane, and Web of Science. On the basis of the fixed-effects model, the pooled sensitivity (SEN), specificity (SPE), and area under the receiver operating characteristics curve (AUC) were calculated to estimate the diagnostic accuracy of 11C-choline PET/CT, 11C-acetate PET/CT, 18F-fluorocholine (FCH) PET/CT, 18F-fluoroglucose (FDG) PET/CT, TRTE, and SWE. All the statistical analyses were conducted with R language Software. The present meta-analysis incorporating a total of 82 studies demonstrated that the pooled sensitivity of the six imaging techniques were sorted as follows: SWE > 18F-FCH PET/CT > 11C-choline PET/CT > TRTE > 11C-acetate PET/CT > 18F-FDG PET/CT; the pooled specificity were also compared: SWE > 18F-FCH PET/CT > 11C-choline PET/CT > TRTE > 18F-FDG PET/CT > 11C-acetate PET/CT; finally, the pooled diagnostic accuracy of the six imaging techniques based on AUC were ranked as below: SWE > 18F-FCH PET/CT > 11C-choline PET/CT > TRTE > 11C-acetate PET/CT > 18F-FDG PET/CT. SWE and 18F-FCH PET/CT imaging could offer more assistance in the early diagnosis of PCa than any other studied imaging techniques. However, the diagnostic ranking of the six imaging techniques might not be applicable to the clinical phase due to the shortage of stratified analysis.
前列腺癌（PCa）的早期诊断对于制定恰当的治疗方案似乎至关重要。尽管已经开发了多种先进的成像技术，如正电子发射断层扫描/计算机断层扫描（PET/CT）和弹性超声成像（ES）用于PCa诊断，但这些成像技术的诊断准确性在一定程度上仍存在争议。因此，本研究进行了一项全面的荟萃分析，以比较各种PCa诊断成像方法的准确性，包括11C-胆碱PET/CT、11C-乙酸盐PET/CT、18F-氟胆碱PET/CT、18F-氟脱氧葡萄糖PET/CT、经直肠实时弹性超声成像（TRTE）和剪切波弹性超声成像（SWE）。通过系统检索包括PubMed、Cochrane和Web of Science在内的电子数据库中的文献来确定符合条件的研究。基于固定效应模型，计算合并敏感度（SEN）、特异度（SPE）和受试者操作特征曲线下面积（AUC），以估计11C-胆碱PET/CT、11C-乙酸盐PET/CT、18F-氟胆碱（FCH）PET/CT、18F-氟脱氧葡萄糖（FDG）PET/CT、TRTE和SWE的诊断准确性。所有统计分析均使用R语言软件进行。本项纳入了总共82项研究的荟萃分析表明，六种成像技术的合并敏感度排序如下：SWE＞18F-FCH PET/CT＞11C-胆碱PET/CT＞TRTE＞11C-乙酸盐PET/CT＞18F-FDG PET/CT；合并特异度也进行了比较：SWE＞18F-FCH PET/CT＞11C-胆碱PET/CT＞TRTE＞18F-FDG PET/CT＞11C-乙酸盐PET/CT；最后，基于AUC对六种成像技术的合并诊断准确性进行排名如下：SWE＞18F-FCH PET/CT＞11C-胆碱PET/CT＞TRTE＞11C-乙酸盐PET/CT＞18F-FDG PET/CT。与任何其他研究的成像技术相比，SWE和18F-FCH PET/CT成像在PCa的早期诊断中可以提供更多帮助。然而，由于缺乏分层分析，六种成像技术的诊断排名可能不适用于临床阶段。
