18F-FDG、11C-蛋氨酸和 18F-FET PET 对胶质瘤分级的性能：一项荟萃分析。
Performance of 18F-FDG, 11C-Methionine, and 18F-FET PET for Glioma Grading: A Meta-analysis.
机构信息
From the Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Bochum, Germany.
Neurosurgical Research Institute, University of Ioannina.
出版信息
Clin Nucl Med. 2019 Nov;44(11):864-869. doi: 10.1097/RLU.0000000000002654.
PURPOSE
Gliomas constitute the most frequent primary brain tumors. Glioblastoma, the most common and malignant glioma in adults, has dismal prognosis with any current therapy. On the other hand, low-grade gliomas, the second most common type of gliomas, are potentially curative with appropriate treatment.
METHODS
We conducted a meta-analysis to assess the performance of PET tracers with the best available evidence, namely, fluorodeoxyglucose (FDG), C-methionine (MET), and F-fluoroethyltyrosine (FET), in differentiating low- from high-grade gliomas.
RESULTS
Twenty-three studies with a total of 994 participants were included in this meta-analysis. The pooled sensitivities of both MET PET and FET PET were found to be significantly higher than of FDG PET (94%, 88%, and 63% respectively, P < 0.001). The pooled specificity of FDG PET was found to be significantly greater compared with both MET PET and FET PET (89%, 55%, and 57%, respectively; P = 0.002). Fluorodeoxyglucose PET was superior in terms of higher positive likelihood ratio values compared with both FET PET and MET PET.
CONCLUSIONS
This meta-analysis indicated that both MET and FET were superior to FDG in terms of sensitivity for identifying glioma grade.
目的
神经胶质瘤是最常见的原发性脑肿瘤。胶质母细胞瘤是成人中最常见和最恶性的神经胶质瘤，任何当前的治疗方法预后都很差。另一方面，低级别神经胶质瘤是第二常见的神经胶质瘤类型，如果给予适当的治疗，是可以治愈的。
方法
我们进行了一项荟萃分析，以评估具有最佳可用证据的 PET 示踪剂（即氟脱氧葡萄糖[FDG]、C-蛋氨酸[MET]和 F-氟乙基酪氨酸[FET]）在区分低级别和高级别神经胶质瘤方面的性能。
结果
本荟萃分析共纳入 23 项研究，共 994 名参与者。发现 MET PET 和 FET PET 的合并敏感性均明显高于 FDG PET（分别为 94%、88%和 63%，P < 0.001）。FDG PET 的合并特异性明显高于 MET PET 和 FET PET（分别为 89%、55%和 57%，P = 0.002）。与 FET PET 和 MET PET 相比，FDG PET 的阳性似然比更高。
结论
本荟萃分析表明，MET 和 FET 在识别胶质瘤分级方面的敏感性均优于 FDG。
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