State Key Laboratory of Oral Diseases, West China Hospital of Stomatology/Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China.
Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China.
Oral Oncol. 2021 May;116:105264. doi: 10.1016/j.oraloncology.2021.105264. Epub 2021 Mar 21.
This study aims to conduct a systematic review and meta-analysis of the performance of PET-CT, CT, and MRI in diagnosing mandible invasion induced by head and neck cancer (HNC).
The MEDLINE, Embase, Science Direct, CNKI and CQVIP databases were searched from inception until August 1, 2020. Then, a meta-analysis was conducted to calculate the combined diagnostic values with the corresponding 95% CIs. Two independent researchers completed the full text screening, data abstraction, and risk assessment.
This meta-analysis included 53 studies (N = 2 946 participants). For the pooled sensitivity (SEN), MRI (SEN: 0.88, 95% CI: 0.81-0.93) was found to have a significantly higher SEN (P = 0.0045), when compared to CT (SEN: 0.77, 95% CI: 0.71-0.82), while compared with PET-CT (SEN: 0.88, 95% CI: 0.64-0.97), the SEN was approximately equal (P > 0.05). The analysis revealed that the combined specificity (SPE) of MRI (SPE: 0.83, 95% CI: 0.74-0.89) and PET-CT (SPE: 0.81, 95% CI: 0.57-0.93) was lower than that of CT (SPE: 0.87, 95% CI: 0.83-0.90), but there was no statistical significance among these (P > 0.05). The comparison of the area under curve (AUC) reflected that PET-CT, CT and MRI have approximately equal summary diagnostic power in detecting mandibular invasion (P > 0.05).
The findings suggest that compared with CT, MRI is significantly superior for higher SEN in diagnosing mandibular invasion. The SEN of MRI and PET-CT were approximately equal. For the summary of diagnostic power, more prospective clinical trials that directly compare these three methods are needed in the future.
本研究旨在对 PET-CT、CT 和 MRI 诊断头颈部癌症（HNC）所致下颌骨侵犯的性能进行系统评价和荟萃分析。
检索 MEDLINE、Embase、Science Direct、CNKI 和 CQVIP 数据库，检索时间从建库至 2020 年 8 月 1 日。然后，进行荟萃分析以计算相应的 95%CI 的合并诊断值。两名独立的研究人员完成了全文筛选、数据提取和风险评估。
本荟萃分析共纳入 53 项研究（N=2946 名参与者）。对于汇总的敏感性（SEN），MRI（SEN：0.88，95%CI：0.81-0.93）的 SEN 显著高于 CT（SEN：0.77，95%CI：0.71-0.82）（P=0.0045），而与 PET-CT 相比（SEN：0.88，95%CI：0.64-0.97），SEN 大致相等（P>0.05）。分析表明，MRI（SPE：0.83，95%CI：0.74-0.89）和 PET-CT（SPE：0.81，95%CI：0.57-0.93）的联合特异性（SPE）低于 CT（SPE：0.87，95%CI：0.83-0.90），但无统计学意义（P>0.05）。曲线下面积（AUC）的比较表明，在检测下颌骨侵犯方面，PET-CT、CT 和 MRI 具有大致相等的综合诊断能力（P>0.05）。
与 CT 相比，MRI 在下颌骨侵犯的高 SEN 诊断方面具有显著优势。MRI 和 PET-CT 的 SEN 大致相等。对于综合诊断能力，未来需要更多直接比较这三种方法的前瞻性临床试验。
