Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Contrast Media Mol Imaging. 2021 Sep 1;2021:5333366. doi: 10.1155/2021/5333366. eCollection 2021.
We performed a systematic review and network meta-analysis (NMA) to compare the diagnostic value of seven different imaging modalities for the detection of neuroblastic tumors in diverse clinical settings.
PubMed, Embase, Medline, and the Cochrane Library were searched to identify eligible studies from inception to Sep 29, 2020. Quality assessment of included studies was appraised with Quality Assessment of Diagnostic Accuracy Studies. Firstly, direct pairwise meta-analysis was conducted to calculate the pooled estimates of odds ratio (OR) and 95% confidence interval (CI) of the sensitivity, specificity, NPV, PPV, and DR. Next, NMA using Bayesian methods was performed. The superiority index was assessed to quantify the rank probability of a diagnostic test. The studies performed SPECT/CT or SPECT were analyzed separately from the ones only performed planar imaging.
A total of 1135 patients from 32 studies, including 7 different imaging modalities, were eligible for this NMA. In the pairwise meta-analysis, F-FDOPA PET/CT had a relatively high value of all the outcomes (sensitivity: 10.195 [5.332-19.493]; specificity: 17.906 [5.950-53.884]; NPV: 16.819 [7.033-40.218]; PPV: 11.154 [4.216-29.512]; and DR 5.616 [3.609-8.739]). In the NMA, F-FDOPA PET/CT exhibited relatively high sensitivity in all subgroups (all data: 0.94 [0.87-0.98]; primary tumor: 0.89 [0.53-1]; bone/bone marrow metastases: 0.96 [0.83-1]; and primary tumor and metastases ( + ): 0.92 [0.80-0.97]), the highest specificity in the subgroup of + (0.85 [0.61-0.97]), and achieved the highest superiority index in the subgroups of all data (8.57 [1-15]) and + (7.25 [1-13]).
F-FDOPA PET/CT exhibited the best diagnostic performance in the comprehensive detection of primary tumor and metastases for neuroblastic tumors, followed by Ga-somatostatin analogs, I-meta-iodobenzylguanidine (MIBG), F-FDG, and I-MIBG tomographic imaging.
我们进行了一项系统评价和网络荟萃分析（NMA），以比较七种不同影像学模式在不同临床环境下检测神经母细胞瘤的诊断价值。
从建库至 2020 年 9 月 29 日，我们在 PubMed、Embase、Medline 和 Cochrane 图书馆中检索了合格的研究。使用诊断准确性研究质量评估工具评估纳入研究的质量。首先，进行直接成对荟萃分析，以计算敏感性、特异性、NPV、PPV 和 DR 的汇总比值比（OR）和 95%置信区间（CI）。然后，使用贝叶斯方法进行 NMA。优势指数用于量化诊断测试的排名概率。对仅行平面成像和同时行 SPECT/CT 或 SPECT 的研究分别进行分析。
共有来自 32 项研究的 1135 名患者符合本 NMA 的纳入标准，包括 7 种不同的影像学模式。在成对荟萃分析中，18F-氟代多巴 PET/CT 在所有结局中均具有较高的价值（敏感性：10.195 [5.332-19.493]；特异性：17.906 [5.950-53.884]；NPV：16.819 [7.033-40.218]；PPV：11.154 [4.216-29.512]；和 DR 5.616 [3.609-8.739]）。在 NMA 中，18F-氟代多巴 PET/CT 在所有亚组（所有数据：0.94 [0.87-0.98]；原发肿瘤：0.89 [0.53-1]；骨/骨髓转移：0.96 [0.83-1]；和原发肿瘤和转移灶（ + ）：0.92 [0.80-0.97]）中具有较高的敏感性，在转移灶（ + ）亚组（0.85 [0.61-0.97]）中具有较高的特异性，在所有数据（8.57 [1-15]）和（ + ）（7.25 [1-13]）亚组中获得了最高的优势指数。
18F-氟代多巴 PET/CT 在神经母细胞瘤的原发肿瘤和转移灶的综合检测中表现出最佳的诊断性能，其次是 Ga-生长抑素类似物、I-间碘苄胍（MIBG）、18F-氟代脱氧葡萄糖（FDG）和 I-MIBG 断层成像。
