18F-FDG-PET/CT与MRI对局部晚期宫颈癌放化疗疗效预测的诊断准确性：一项Meta分析

Diagnostic Accuracy of 18F-FDG-PET/CT and MRI in Predicting the Tumor Response in Locally Advanced Cervical Carcinoma Treated by Chemoradiotherapy: A Meta-Analysis.

作者信息

Sanei Sistani Sharareh, Parooie Fateme, Salarzaei Morteza

机构信息

Department of Radiology, School Medicine, Zahedan University of Medical Science, Zahedan, Iran.

Student Research Committee, Zabol University of Medical Science, Zabol, Iran.

出版信息

Contrast Media Mol Imaging. 2021 Mar 2;2021:8874990. doi: 10.1155/2021/8874990. eCollection 2021.

OBJECTIVE

The aim of this meta-analysis was to compare the diagnostic accuracy of 18F-FDG-PET/CT and MRI in predicting the tumor response in locally advanced cervical carcinoma (LACC) treated by chemoradiotherapy (CRT).

METHOD

This meta-analysis has been performed according to PRISMA guidelines. Systematic searches were conducted using PubMed and Embase databases for articles published from January 1, 2010, to January 1, 2020. By using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool, the reviewers assessed the methodological quality scores of the selected studies. We analyzed the sensitivity, specificity, and accuracy of two diagnostic methods using Meta-DiSc 1.4 and Stata 15.

RESULTS

An overall of 15 studies including 1132 patients were included. Sensitivities of PET/CT and MRI were 83.5% and 82.7%, while the corresponding rates for specificities were 77.8% and 68.4%, respectively. The DOR, PLR, and NLR for MRI were 15.140, 2.92, and 22.6. PET/CT had a DOR of 25.21. The PLR and NLR for PET/CT were 4.13 and 0.215, respectively. The diagnostic sensitivity and specificity of PET/CT for the detection of residual tumor were 86% and 95%, respectively. The corresponding rates for MRI were 73% and 96%, respectively. The diagnostic sensitivity and specificity of PET/CT for the detection of tumor metastases were 97% and 99%, while the corresponding rates for MRI were 31% and 98%, respectively.

CONCLUSION

18F-FDG PET/CT seemed to have a better overall diagnostic accuracy in the evaluation of treatment response to chemoradiotherapy in LACC patients. MRI showed a really poor sensitivity in the detection of metastases, and PET/CT performed significantly better. However, the difference between these two methods in the detection of residual disease was not significant. More studies are needed to be conducted in order to approve that 18F-FDG PET/CT can be a standard option to assess the treatment response.

目的

本荟萃分析的目的是比较18F-FDG-PET/CT和MRI在预测接受放化疗（CRT）的局部晚期宫颈癌（LACC）患者肿瘤反应方面的诊断准确性。

方法

本荟萃分析按照PRISMA指南进行。使用PubMed和Embase数据库对2010年1月1日至2020年1月1日发表的文章进行系统检索。使用诊断准确性研究质量评估2（QUADAS-2）工具，评审人员评估所选研究的方法学质量得分。我们使用Meta-DiSc 1.4和Stata 15分析两种诊断方法的敏感性、特异性和准确性。

结果

共纳入15项研究，包括1132例患者。PET/CT和MRI的敏感性分别为83.5%和82.7%，而相应的特异性率分别为77.8%和68.4%。MRI的诊断比值比（DOR）、阳性似然比（PLR）和阴性似然比（NLR）分别为15.140、2.92和22.6。PET/CT的DOR为25.21。PET/CT的PLR和NLR分别为4.13和0.215。PET/CT检测残留肿瘤的诊断敏感性和特异性分别为86%和95%。MRI的相应率分别为73%和96%。PET/CT检测肿瘤转移的诊断敏感性和特异性分别为97%和99%，而MRI的相应率分别为31%和98%。