MRI、CT和18F-FDG PET/CT在鼻咽癌局部及转移诊断中的比较：临床研究的最新荟萃分析
Comparison of MRI, CT and 18F-FDG PET/CT in the diagnosis of local and metastatic of nasopharyngeal carcinomas: an updated meta analysis of clinical studies.
作者信息
Chen Wang-Sheng, Li Jian-Jun, Hong Lan, Xing Zeng-Bao, Wang Fen, Li Chang-Qing
机构信息
Department of Radiology, People's Hospital of Hainan Province Haikou 570311, China.
Department of Gynacology, People's Hospital of Hainan Province Haikou 570311, China.
出版信息
Am J Transl Res. 2016 Nov 15;8(11):4532-4547. eCollection 2016.
BACKGROUND
A meta-analysis was conducted to evaluate the accuracy of MRI, CT and FDG PET/CT in TNM stage of nasopharyngeal carcinoma patients (NPC).
METHODS
Through a search of studies from 1996 to April 2015, pooled estimated sensitivity, specificity, pooled diagnostic odds ratio (DOR), summary receiver operating characteristic (SROC) curves and Q*-index were calculated.
RESULTS
Totally 23 studies were included for analysis. In T stage, the pooled sensitivity, specificity, DOR and SROC of MRI were 0.95 (95% CI 0.93-0.97), 0.76 (95% CI 0.71-0.80), 86.85 (16.36-461.06) and 0.9213 (SE 0.0372) respectively. The pooled sensitivity, specificity, DOR and SROC of CT were 0.84 (95% CI 0.79 to 0.88), 0.80 (95% CI 0.71 to 0.88), 6.32 (1.17 to 34.02) and 0.7215 (SE 0.054) respectively. The pooled sensitivity, specificity, DOR and SROC of FDG PET/CT were 0.85 (95% CI 0.76 to 0.91), 0.91 (95% CI 0.84 to 0.96) and 0.8673 (SE 0.0311). In N stage, the pooled sensitivity, specificity, DOR and SROC of MRI were 0.88 (95% CI 0.85-0.90), 0.95 (95% CI 0.93-0.97), 93.68 (23.21-379.69) and 0.9153 (SE 0.099) respectively. The pooled sensitivity, specificity, DOR and SROC of CT were 0.92 (95% CI 0.88-0.95), 0.93 (0.76-0.99), 93.81 (22.39-393.03) and 0.8872 (SE 0.0520) respectively. The pooled sensitivity, specificity, DOR and SROC of FDG PET/CT were 0.88 (95% CI 0.85-0.90), 0.95 (95% CI 0.93-0.97), 93.88 (23.21-379.69) and 0.9153 (SE 0.0299) respectively. In M stage, the pooled sensitivity and specificity of MRI were 0.53 (95% CI 0.35-0.70) and 0.99 (95% 0.95-1.00). The pooled sensitivity and specificity of CT were 0.80 (95% CI 0.44-0.97) and 0.93 (95% CI 0.86-0.97) respectively. The pooled sensitivity, specificity and SROC of FDG PET/CT were 0.82 (95% 0.74-0.88), 0.98 (95% CI 0.96-0.99) and 0.9002 (SE 0.075) respectively.
CONCLUSION
The analysis suggested that MRI had good accuracy in diagnosis of T stage. Whereas CT is currently a good performance in diagnosis of N stage, FDG PET/CT shows good accuracy in diagnosis of M stage.
背景
进行一项荟萃分析以评估MRI、CT和FDG PET/CT在鼻咽癌患者（NPC）TNM分期中的准确性。
方法
通过检索1996年至2015年4月的研究，计算合并估计灵敏度、特异性、合并诊断比值比（DOR）、汇总受试者工作特征（SROC）曲线和Q*指数。
结果
共纳入23项研究进行分析。在T分期中，MRI的合并灵敏度、特异性、DOR和SROC分别为0.95（95%CI 0.93 - 0.97）、0.76（95%CI 0.71 - 0.80）、86.85（16.36 - 461.06）和0.9213（SE 0.0372）。CT的合并灵敏度、特异性、DOR和SROC分别为0.84（95%CI 0.79至0.88）、0.80（95%CI 0.71至0.88）、6.32（1.17至34.02）和0.7215（SE 0.054）。FDG PET/CT的合并灵敏度、特异性、DOR和SROC分别为0.85（95%CI 0.76至0.91）、0.91（95%CI 0.84至0.96）和0.8673（SE 0.0311）。在N分期中，MRI的合并灵敏度、特异性、DOR和SROC分别为0.88（95%CI 0.85 - 0.90）、0.95（95%CI 0.93 - 0.97）、93.68（23.21 - 379.69）和0.9153（SE 0.099）。CT的合并灵敏度、特异性、DOR和SROC分别为0.92（95%CI 0.88 - 0.95）、0.93（0.76 - 0.99）、93.81（22.39 - 393.03）和0.8872（SE 0.0520）。FDG PET/CT的合并灵敏度、特异性、DOR和SROC分别为0.88（95%CI 0.85 - 0.90）、0.95（95%CI 0.93 - 0.97）、93.88（23.21 - 379.69）和0.9153（SE 0.0299）。在M分期中，MRI的合并灵敏度和特异性分别为0.53（95%CI 0.35 - 0.70）和0.99（95% 0.95 - 1.00）。CT的合并灵敏度和特异性分别为0.80（95%CI 0.44 - 0.97）和0.93（95%CI 0.86 - 0.97）。FDG PET/CT的合并灵敏度、特异性和SROC分别为0.82（95% 0.74 - 0.88）、0.98（95%CI 0.96 - 0.99）和0.9002（SE 0.075）。
结论
分析表明MRI在T分期诊断中具有良好的准确性。而CT目前在N分期诊断中表现良好，FDG PET/CT在M分期诊断中显示出良好的准确性。
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