Department of Radiology, Jinan Central Hospital, Shangdong First Medical University, Jinan, China.
Department of Otolaryngology, Chongqing Qianjiang National Hospital, China.
Adv Clin Exp Med. 2022 Aug;31(8):827-835. doi: 10.17219/acem/147359.
Perineural spread of head and neck tumors is linked to a worse chance of survival as well as a higher risk of local recurrence and metastasis. Particle emission tomography/computed tomography (PET/CT) using 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG) is part of the work-up and follow-up of many afflicted patients, and radiologists play an essential role in the assessment and management of head and neck cancer.
The purpose of the current study was to investigate the diagnostic performance of 18F-FDG PET in detecting perineural spread among patients with head and neck tumors through a meta-analysis.
Relevant articles were searched using appropriate keywords from PubMed, MEDLINE and PubMed Central (PMC) databases. Retrospective and prospective studies were included as per the predefined PICOS criteria. Demographic summary and event data for diagnostic accuracy of 18F-FDG PET were determined, and odds ratio (OR), sensitivity, specificity, likelihood ratios, and predictive values were calculated using RevMan software. The bias risk was analyzed with Egger's and Begg's tests using MedCalc software.
Fourteen clinical trials performed between 2000 and 2021, with 977 head and neck cancer patients with perineural spread, were included according to the inclusion criteria. Included studies used 18F-FDG PET imaging of tumors and reported its high sensitivity. In the current study, we obtained the pooled OR = 3.088 (95% confidence interval (95% CI): [1.486; 6.419]), pooled sensitivity of 91.7%, pooled specificity of 92.35%, positive predictive value (PPV) of 92.27%, negative predictive value (NPV) of 91.13%, positive likelihood ratio of 7.45, negative likelihood ratio of 0.28, disease prevalence of 95.8%, and accuracy of 91.5%. Data was heterogeneous, with Q value of 33.8%, degrees of freedom (df) value of 13, I2 value of 61.5% (31.23-78.5), and p-value = 0.0013. The risk of publication bias was low, with a p = 0.7490 (Egger's test) and p = 0.7843 (Begg's test).
The present meta-analysis highly recommends 18F-FDG PET as an effective imaging method for patients with head and neck tumors with perineural spread.
头颈部肿瘤的神经周围扩散与生存机会较差以及局部复发和转移风险较高有关。使用 2-[氟-18]氟-2-脱氧-d-葡萄糖（FDG）的正电子发射断层扫描/计算机断层扫描（PET/CT）是许多受影响患者的检查和随访的一部分，放射科医生在评估和管理头颈部癌症方面发挥着重要作用。
本研究旨在通过荟萃分析探讨 18F-FDG PET 在检测头颈部肿瘤患者神经周围扩散中的诊断性能。
使用适当的关键字从 PubMed、MEDLINE 和 PubMed Central（PMC）数据库中搜索相关文章。根据预设的 PICOS 标准，纳入回顾性和前瞻性研究。使用 RevMan 软件确定 18F-FDG PET 诊断准确性的人口统计学总结和事件数据，并计算比值比（OR）、敏感性、特异性、似然比和预测值。使用 MedCalc 软件分析 Egger 和 Begg 检验的偏倚风险。
根据纳入标准，共纳入了 2000 年至 2021 年间进行的 14 项临床试验，涉及 977 例有神经周围扩散的头颈部癌症患者。纳入的研究使用 18F-FDG PET 对肿瘤进行成像，并报告了其高敏感性。在本研究中，我们获得了合并 OR = 3.088（95%置信区间（95%CI）：[1.486; 6.419]），合并敏感性为 91.7%，合并特异性为 92.35%，阳性预测值（PPV）为 92.27%，阴性预测值（NPV）为 91.13%，阳性似然比为 7.45，阴性似然比为 0.28，疾病患病率为 95.8%，准确率为 91.5%。数据存在异质性，Q 值为 33.8%，自由度（df）值为 13，I2 值为 61.5%（31.23-78.5），p 值=0.0013。发表偏倚风险较低，p = 0.7490（Egger 检验）和 p = 0.7843（Begg 检验）。
本荟萃分析强烈推荐 18F-FDG PET 作为一种有效的头颈部肿瘤伴神经周围扩散患者的成像方法。
