氟代脱氧葡萄糖正电子发射断层扫描或正电子发射断层扫描/计算机断层扫描对鉴别良恶性椎体压缩性骨折的诊断性能：荟萃分析。
Diagnostic Performance of F-18 Fluorodeoxyglucose Positron Emission Tomography or Positron Emission Tomography/Computed Tomography for Differentiation of Benign and Malignant Vertebral Compression Fractures: A Meta-Analysis.
机构信息
Department of Nuclear Medicine, BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, and Department of Nuclear Medicine, College of Medicine, Pusan National University, Yangsan, Republic of Korea.
Department of Orthopaedic Surgery, BioMedical Research Institute, Pusan National University Hospital, Pusan National University, Busan, Republic of Korea.
出版信息
World Neurosurg. 2020 May;137:e626-e633. doi: 10.1016/j.wneu.2020.02.085. Epub 2020 Feb 24.
OBJECTIVE
The purpose of the present study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the differentiation of benign and malignant vertebral compression fractures (VCFxs) through a systematic review and meta-analysis.
METHODS
MEDLINE via PubMed, Cochrane, Scopus, and Embase database, from the earliest available date of indexing through September 30, 2019, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT for the differentiation of malignant VCFxs. We determined the sensitivities and specificities across the studies, calculated the positive and negative likelihood ratios (LR and LR, respectively), and constructed summary receiver operating characteristic curves.
RESULTS
For the 5 studies (274 patients), the pooled sensitivity was 0.96 (95% confidence interval [CI], 0.82-0.99) without heterogeneity (I, 50.6) and 0.77 (95% CI, 0.56-0.89) with heterogeneity (I, 76.1). LR syntheses gave an overall LR of 4.1 (95% CI, 2.1-8.0) and LR of 0.05 (95% CI, 0.01-0.23). The pooled diagnostic odds ratio (DOR) was 78 (95% CI, 19-316). The hierarchical summary receiver operating characteristic curve indicates that the areas under the curve was 0.94 (95% CI, 0.92-0.96).
CONCLUSIONS
The results of the present meta-analysis have shown high sensitivity and moderate specificity for F-18 FDG PET and PET/CT for differentiation of malignant VCFxs. At present, the reported data regarding the use of F-18 FDG PET for differentiation of malignant VCFxs remain limited; thus, further large multicenter studies are necessary to substantiate the diagnostic accuracy of F-18 FDG PET for the differentiation of malignant VCFxs.
目的
本研究旨在通过系统评价和荟萃分析，探讨 18F 氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）在鉴别良恶性椎体压缩性骨折（VCFx）中的诊断性能。
方法
通过 MEDLINE 数据库（PubMed）、Cochrane 图书馆、Scopus 和 Embase 数据库，从最早的可检索日期到 2019 年 9 月 30 日，检索评估 18F FDG PET 或 PET/CT 鉴别恶性 VCFx 诊断性能的研究。我们确定了研究之间的敏感性和特异性，计算了阳性和阴性似然比（LR 和 LR，分别），并构建了汇总受试者工作特征曲线。
结果
纳入的 5 项研究（274 例患者）中，无异质性时（I²=50.6%），合并敏感性为 0.96（95%置信区间 [CI]，0.82-0.99），异质性存在时（I²=76.1%），合并敏感性为 0.77（95% CI，0.56-0.89）。LR 综合分析显示，总体 LR 为 4.1（95% CI，2.1-8.0），LR 为 0.05（95% CI，0.01-0.23）。合并诊断比值比（DOR）为 78（95% CI，19-316）。分层汇总受试者工作特征曲线表明，曲线下面积为 0.94（95% CI，0.92-0.96）。
结论
本荟萃分析结果表明，18F FDG PET 和 PET/CT 对恶性 VCFx 的鉴别具有较高的敏感性和中等特异性。目前，关于 18F FDG PET 鉴别恶性 VCFx 的报道数据仍然有限；因此，需要进一步进行大型多中心研究来证实 18F FDG PET 鉴别恶性 VCFx 的诊断准确性。
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