Hu Xianwen, Liang Zhigang, Zhang Chuanqin, Wang Guanlian, Cai Jiong, Wang Pan
Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Research and Development Department, Jiangsu Yuanben Biotechnology Co., Ltd., Zunyi, China.
Front Oncol. 2022 Feb 9;12:840433. doi: 10.3389/fonc.2022.840433. eCollection 2022.
The purpose of this meta-analysis was to provide evidence for using maximum uptake value (SUVmax) and apparent diffusion coefficient (ADC) to quantitatively differentiate benign and malignant ovarian or adnexal masses, and to indirectly compare their diagnostic performance.
The association between SUVmax, ADC and ovarian or adnexal benign and malignant masses was searched in PubMed, Cochrane Library, and Embase databases until October 1, 2021. Two authors independently extracted the data. Studies included in the analysis were required to provide data for the construction of a 2 × 2 contingency table to evaluate the diagnostic performance of SUVmax or ADC in differentiating benign and malignant ovarian or adnexal masses. The quality of the enrolled studies was evaluated by Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) instrument, and the meta-analysis was conducted using Stata software version 14.0. Forest plots were generated according to the sensitivity and specificity of SUVmax and ADC, and meta-regression analysis was further used to assess heterogeneity between studies.
A total of 14 studies were finally included in this meta-analysis by gradually excluding duplicate literatures, conference abstracts, guidelines, reviews, case reports, animal studies and so on. The pooled sensitivity and specificity of SUVmax for quantitative differentiation of benign and malignant ovarian or adnexal masses were 0.88 and 0.89, respectively, and the pooled sensitivity and specificity for ADC were 0.87 and 0.80, respectively.
Quantitative SUVmax and ADC values have good diagnostic performance in differentiating benign and malignant ovarian or adnexal masses, and SUVmax has higher accuracy than ADC. Future prospective studies with large sample sizes are needed for the analysis of the role of SUVmax and ADC in the differentiation of benign and malignant ovarian or adnexal masses.
本荟萃分析的目的是为使用最大摄取值(SUVmax)和表观扩散系数(ADC)定量鉴别卵巢或附件良恶性肿块提供证据,并间接比较它们的诊断性能。
在PubMed、Cochrane图书馆和Embase数据库中检索截至2021年10月1日SUVmax、ADC与卵巢或附件良恶性肿块之间的关联。两位作者独立提取数据。纳入分析的研究需提供构建2×2列联表的数据,以评估SUVmax或ADC在鉴别卵巢或附件良恶性肿块中的诊断性能。采用诊断准确性研究质量评估-2(QUADAS-2)工具评估纳入研究的质量,并使用Stata软件14.0版进行荟萃分析。根据SUVmax和ADC的敏感性和特异性生成森林图,并进一步进行荟萃回归分析以评估研究间的异质性。
通过逐步排除重复文献、会议摘要、指南、综述、病例报告、动物研究等,本荟萃分析最终纳入14项研究。SUVmax定量鉴别卵巢或附件良恶性肿块的合并敏感性和特异性分别为0.88和0.89,ADC的合并敏感性和特异性分别为0.87和0.80。
SUVmax和ADC定量值在鉴别卵巢或附件良恶性肿块方面具有良好的诊断性能,且SUVmax的准确性高于ADC。未来需要进行大样本量的前瞻性研究,以分析SUVmax和ADC在卵巢或附件良恶性肿块鉴别中的作用。