不同影像学技术在头颈部癌症下颌骨侵犯诊断中的表现：系统评价和荟萃分析。
Performance of different imaging techniques in the diagnosis of head and neck cancer mandibular invasion: A systematic review and meta-analysis.
机构信息
Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.
Department of Prosthodontics, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.
出版信息
Oral Oncol. 2018 Nov;86:150-164. doi: 10.1016/j.oraloncology.2018.09.024. Epub 2018 Sep 25.
BACKGROUND
To assess diagnostic efficacy of imaging techniques for mandibular invasion by head and neck cancer.
METHODS
Thirteen databases were searched. Study inclusion, data-extraction and quality assessment were performed independently. STATA 14.0 were mainly used for meta-analysis.
RESULTS
Forty-nine studies were included. For mandibular invasion (cortex and marrow), CBCT, SPECT, CT, MRI, orthopantomography, PET-CT and bone-scintigraphy showed pooled sensitivities of 90%, 97%, 73%, 88%, 75%, 90%, 92%, specificities of 85%, 69% 91%, 90%, 83%, 89%, 79%, AUC of 0.9461, 0.9434, 0.8995, 0.9296, 0.8761, 0.9290, 0.9207, respectively. The combined SROC curves indicated CBCT and SPECT were superior to other techniques. For mandibular medullary invasion (marrow), CT and MRI showed pooled sensitivities of 85% and 93%, specificities of 86% and 84%.
CONCLUSIONS
CBCT was top-priority choice for bone invasion diagnosis. SPECT was recommended for exclusion, CT and MRI were suitable for conformation. Further investigations are needed for mandibular medullary involvement.
背景
评估头颈部癌症下颌骨侵犯的影像学技术的诊断效能。
方法
检索了 13 个数据库。独立进行了研究纳入、数据提取和质量评估。主要使用 STATA 14.0 进行荟萃分析。
结果
共纳入 49 项研究。对于下颌骨侵犯（皮质和骨髓），CBCT、SPECT、CT、MRI、全景片、PET-CT 和骨闪烁显像的汇总敏感度分别为 90%、97%、73%、88%、75%、90%、92%，特异性分别为 85%、69%、91%、90%、83%、89%、79%，AUC 分别为 0.9461、0.9434、0.8995、0.9296、0.8761、0.9290、0.9207。联合 SROC 曲线表明 CBCT 和 SPECT 优于其他技术。对于下颌骨髓质侵犯（骨髓），CT 和 MRI 的汇总敏感度分别为 85%和 93%，特异性分别为 86%和 84%。
结论
CBCT 是骨侵犯诊断的首选方法。SPECT 推荐用于排除，CT 和 MRI 适合用于证实。对于下颌骨髓质受累，需要进一步研究。
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