Yeo Jing Ming, Waddell Briony, Khan Zubair, Pal Suvankar
College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.
Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK; Division of Clinical Neurosciences, Western General Hospital, Edinburgh, UK.
Alzheimers Dement (Amst). 2015 Mar 29;1(1):5-13. doi: 10.1016/j.dadm.2014.11.004. eCollection 2015 Mar.
Amyloid imaging using fluorine 18-labeled tracers florbetapir, florbetaben, and flutemetamol has recently been reported in Alzheimer's disease (AD).
We systematically searched MEDLINE and EMBASE for relevant studies published from January 1980 to March 2014. Studies comparing imaging findings in AD and normal controls (NCs) were pooled in a meta-analysis, calculating pooled weighted sensitivity, specificity, and diagnostic odds ratio (OR) using the DerSimonian-Laird random-effects model.
Nineteen studies, investigating 682 patients with AD, met inclusion criteria. Meta-analysis demonstrated a sensitivity of 89.6%, a specificity of 87.2%, and an OR of 91.7 for florbetapir in differentiating AD patients from NCs, and a sensitivity of 89.3%, a specificity of 87.6%, and a diagnostic OR of 69.9 for florbetaben. There were insufficient data to complete analyses for flutemetamol.
Results suggest favorable sensitivity and specificity of amyloid imaging with fluorine 18-labeled tracers in AD. Prospective studies are required to determine optimal imaging analysis methods and resolve outstanding clinical uncertainties.
近期有报道称，在阿尔茨海默病（AD）中使用氟18标记的示踪剂氟比他班、氟贝他班和氟代甲磺酸去甲肾上腺素进行淀粉样蛋白成像。
我们系统检索了MEDLINE和EMBASE数据库，查找1980年1月至2014年3月发表的相关研究。将比较AD患者和正常对照（NCs）成像结果的研究纳入荟萃分析，使用DerSimonian-Laird随机效应模型计算合并加权敏感性、特异性和诊断比值比（OR）。
19项研究共纳入682例AD患者，符合纳入标准。荟萃分析显示，氟比他班区分AD患者和NCs的敏感性为89.6%，特异性为87.2% ，OR为91.7；氟贝他班的敏感性为89.3%，特异性为87.6%，诊断OR为69.9。氟代甲磺酸去甲肾上腺素的数据不足，无法完成分析。
结果表明，在AD中使用氟18标记的示踪剂进行淀粉样蛋白成像具有良好的敏感性和特异性。需要进行前瞻性研究，以确定最佳成像分析方法，并解决尚存的临床不确定性问题。
