Luo Mingxu, Song Hongmei, Liu Gang, Lin Yikai, Luo Lintao, Zhou Xin, Chen Bo
Department of Gastrointestinal Surgery, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, China.
Department of Oncology, Renmin Hospital of Shiyan, Hubei University of Medicine, Shiyan, China.
Oncotarget. 2017 Sep 19;8(48):84473-84488. doi: 10.18632/oncotarget.21055. eCollection 2017 Oct 13.
The diagnostic values of diffusion weighted imaging (DWI) and F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) for N-staging of gastric cancer (GC) were identified and compared. After a systematic search to identify relevant articles, meta-analysis was used to summarize the sensitivities, specificities, and areas under curves (AUCs) for DWI and PET/CT. To better understand the diagnostic utility of DWI and PET/CT for N-staging, the performance of multi-detector computed tomography (MDCT) was used as a reference. Fifteen studies were analyzed. The pooled sensitivity, specificity, and AUC with 95% confidence intervals of DWI were 0.79 (0.73-0.85), 0.69 (0.61-0.77), and 0.81 (0.77-0.84), respectively. For PET/CT, the corresponding values were 0.52 (0.39-0.64), 0.88 (0.61-0.97), and 0.66 (0.62-0.70), respectively. Comparison of the two techniques revealed DWI had higher sensitivity and AUC, but no difference in specificity. DWI exhibited higher sensitivity but lower specificity than MDCT, and F-FDG PET/CT had lower sensitivity and equivalent specificity. Overall, DWI performed better than F-FDG PET/CT for preoperative N-staging in GC. When the efficacy of MDCT was taken as a reference, DWI represented a complementary imaging technique, while F-FDG PET/CT had limited utility for preoperative N-staging.
本研究旨在确定并比较弥散加权成像（DWI）和氟脱氧葡萄糖正电子发射断层显像/计算机断层扫描（F-FDG PET/CT）在胃癌（GC）N分期中的诊断价值。在系统检索相关文献后，采用荟萃分析总结DWI和PET/CT的敏感性、特异性及曲线下面积（AUC）。为更好地理解DWI和PET/CT在N分期中的诊断效用，将多排螺旋计算机断层扫描（MDCT）的表现作为参照。共分析了15项研究。DWI的合并敏感性、特异性及95%置信区间的AUC分别为0.79（0.73-0.85）、0.69（0.61-0.77）和0.81（0.77-0.84）。PET/CT的相应值分别为0.52（0.39-0.64）、0.88（0.61-0.97）和0.66（0.62-0.70）。两种技术比较显示，DWI具有更高的敏感性和AUC，但特异性无差异。DWI的敏感性高于MDCT，特异性低于MDCT；F-FDG PET/CT的敏感性较低，特异性相当。总体而言，在GC术前N分期中，DWI的表现优于F-FDG PET/CT。以MDCT的效能为参照时，DWI是一种补充性成像技术，而F-FDG PET/CT在术前N分期中的效用有限。
