F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描在骨转移检测中的诊断性能：一项荟萃分析。

The diagnostic performance of F-fluoride PET/CT in bone metastases detection: a meta-analysis.

机构信息

The First School of Clinical Medicine, Nanjing Medical University, Nanjing, 210029, Jiangsu, China.

Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, 214063, Jiangsu, China.

出版信息

Clin Radiol. 2019 Mar;74(3):196-206. doi: 10.1016/j.crad.2018.12.011. Epub 2019 Jan 14.

DOI:10.1016/j.crad.2018.12.011

PMID:30648535

Abstract

AIM

To assess the diagnostic performance of combined F-fluoride positron-emission tomography (PET)/computed tomography (CT) in bone metastases (BM) and explore whether there is an added value when compared with Tc- methylene diphosphonate (MDP) planar bone scintigraphy (BS).

MATERIALS AND METHODS

PubMed, EMBASE, Web of Science, and the Cochrane Library were searched to December 2017. Studies evaluating the performance of F-fluoride PET/CT in BM detection and using histopathology or clinical/imaging follow-up for ≥6 months as the reference standard were included. All analyses were performed on Stata/SE 12.0 and MetaDisc 1.4.

RESULTS

Twenty articles comprising 1,349 patients were included. On the patient basis, the pooled sensitivity and specificity of F-fluoride PET/CT were 93% (95% confidence interval [CI], 91-96%) and 95% (95% CI, 93-96%) when equivocal results were considered as negative for BM; and 96% (95% CI, 93-97%) and 93% (95% CI, 91-95%) when equivocal results were considered as positive. On the lesion basis, the pooled sensitivity and specificity were 93% (95% CI, 92-94%) and 96% (95% CI, 95-97%) when equivocal results were considered as negative; and 94% (95% CI, 92-95%) and 95% (95% CI, 94-96%) when equivocal results were considered as positive. Seven articles reported the comparison between F-fluoride PET/CT and Tc-MDP BS. F-fluoride PET/CT showed both higher sensitivity (p<0.005) and specificity (p<0.05) when equivocal results were considered as positive. When the equivocal results were considered as negative, F-fluoride PET/CT showed higher sensitivity (p<0.005), but no significant difference in specificity (p=0.08).

CONCLUSIONS

F-fluoride PET/CT showed superior diagnostic performance in BM detection and had higher accuracy when compared with Tc-MDP BS.

摘要

目的

评估氟-18 正电子发射断层扫描（PET）/计算机断层扫描（CT）联合检测骨转移（BM）的诊断性能，并探讨其与锝-亚甲基二膦酸盐（MDP）平面骨闪烁扫描（BS）相比是否具有附加价值。

材料与方法

检索了 PubMed、EMBASE、Web of Science 和 Cochrane 图书馆，截至 2017 年 12 月。纳入评估氟-18 PET/CT 检测 BM 性能并以组织病理学或临床/影像学随访≥6 个月作为参考标准的研究。所有分析均在 Stata/SE 12.0 和 MetaDisc 1.4 上进行。

结果

共纳入 20 篇文章，包含 1349 例患者。基于患者的结果，氟-18 PET/CT 的汇总敏感度和特异度在将不确定结果视为 BM 阴性时分别为 93%（95%置信区间[CI]，91-96%）和 95%（95% CI，93-96%）；而将不确定结果视为 BM 阳性时分别为 96%（95% CI，93-97%）和 93%（95% CI，91-95%）。基于病灶的结果，当将不确定结果视为 BM 阴性时，汇总敏感度和特异度分别为 93%（95% CI，92-94%）和 96%（95% CI，95-97%）；而将不确定结果视为 BM 阳性时分别为 94%（95% CI，92-95%）和 95%（95% CI，94-96%）。7 篇文章报告了氟-18 PET/CT 与 Tc-MDP BS 之间的比较。当将不确定结果视为阳性时，氟-18 PET/CT 显示出更高的敏感度（p<0.005）和特异度（p<0.05）。当将不确定结果视为阴性时，氟-18 PET/CT 显示出更高的敏感度（p<0.005），但特异度无显著差异（p=0.08）。