Department of Nuclear MedicinePusan National University Yangsan Hospital, Yangsan, Korea
BioMedical Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan Hospital, Yangsan, Korea.
Endocr Relat Cancer. 2018 Jun;25(6):643-652. doi: 10.1530/ERC-17-0341. Epub 2018 Mar 20.
We aimed to explore the role of the diagnostic accuracy of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for the detection of recurrent and/or metastatic diseases in differentiated thyroid cancer (DTC) patients with progressively and/or persistently elevated TgAb levels and negative radioactive iodine whole-body scan (RI-WBS) through a systematic review and meta-analysis. The MEDLINE, EMBASE and Cochrane Library database, from the earliest available date of indexing through June 30, 2017, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for the detection of recurrent and/or metastatic diseases in DTC patients with progressively and/or persistently elevated TgAb levels and negative RI-WBS. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-). Across 9 studies (515 patients), the pooled sensitivity for F-18 FDG PET/CT was 0.84 (95% CI; 0.77-0.89) a pooled specificity of 0.78 (95% CI; 0.67-0.86). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 3.8 (95% CI; 2.5-5.7) and negative likelihood ratio (LR-) of 0.21 (95% CI; 0.14-0.30). The pooled diagnostic odds ratio (DOR) was 18 (95% CI; 10-34). The area (AUC) under the hierarchical summary receiver-operating characteristic (HCROC) curve was 0.88 (95% CI: 0.85-0.90). F-18 FDG PET or PET/CT demonstrated moderate sensitivity and specificity for the detection of recurrent and/or metastatic diseases in DTC patients with progressively and/or persistently elevated TgAb levels and negative RI-WBS.
我们旨在通过系统评价和荟萃分析，探讨 F-18 氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）在 TgAb 水平逐渐升高和/或持续升高且放射性碘全身扫描（RI-WBS）阴性的分化型甲状腺癌（DTC）患者中检测复发和/或转移疾病的诊断准确性。检索了 MEDLINE、EMBASE 和 Cochrane Library 数据库，检索时间为最早索引日期至 2017 年 6 月 30 日，以评估 F-18 FDG PET/CT 在 TgAb 水平逐渐升高和/或持续升高且 RI-WBS 阴性的 DTC 患者中检测复发和/或转移疾病的诊断性能。我们确定了研究中的敏感性和特异性，计算了阳性和阴性似然比（LR+和 LR-）。在 9 项研究（515 例患者）中，F-18 FDG PET/CT 的汇总敏感性为 0.84（95%CI；0.77-0.89），汇总特异性为 0.78（95%CI；0.67-0.86）。似然比（LR）综合分析得出总体阳性似然比（LR+）为 3.8（95%CI；2.5-5.7），阴性似然比（LR-）为 0.21（95%CI；0.14-0.30）。汇总诊断比值比（DOR）为 18（95%CI；10-34）。分层汇总受试者工作特征（HCROC）曲线下面积（AUC）为 0.88（95%CI：0.85-0.90）。F-18 FDG PET 或 PET/CT 对 TgAb 水平逐渐升高和/或持续升高且 RI-WBS 阴性的 DTC 患者中检测复发和/或转移疾病具有中等敏感性和特异性。
