磁共振成像（MRI）与氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）在局部晚期直肠癌患者新辅助治疗反应诊断中的比较

MRI VS. FDG-PET for diagnosis of response to neoadjuvant therapy in patients with locally advanced rectal cancer.

作者信息

Gao Peng Fei, Lu Na, Liu Wen

机构信息

Department of Traditional Chinese medicine, Jinshan Hospital, Fudan University, Shanghai, China.

Department of Radiology, Huashan Hospital North, Fudan University, Shanghai, China.

出版信息

Front Oncol. 2023 Jan 18;13:1031581. doi: 10.3389/fonc.2023.1031581. eCollection 2023.

AIM

In this study, we aimed to compare the diagnostic values of MRI and FDG-PET for the prediction of the response to neoadjuvant chemoradiotherapy (NACT) of patients with locally advanced Rectal cancer (RC).

METHODS

Electronic databases, including PubMed, Embase, and the Cochrane library, were systematically searched through December 2021 for studies that investigated the diagnostic value of MRI and FDG-PET in the prediction of the response of patients with locally advanced RC to NACT. The quality of the included studies was assessed using QUADAS. The pooled sensitivity, specificity, positive and negative likelihood ratio (PLR and NLR), and the area under the ROC (AUC) of MRI and FDG-PET were calculated using a bivariate generalized linear mixed model, random-effects model, and hierarchical regression.

RESULTS

A total number of 74 studies with recruited 4,105 locally advanced RC patients were included in this analysis. The pooled sensitivity, specificity, PLR, NLR, and AUC for MRI were 0.83 (95% CI: 0.77-0.88), 0.85 (95% CI: 0.79-0.89), 5.50 (95% CI: 4.11-7.35), 0.20 (95% CI: 0.14-0.27), and 0.91 (95% CI: 0.88-0.93), respectively. The summary sensitivity, specificity, PLR, NLR and AUC for FDG-PET were 0.81 (95% CI: 0.77-0.85), 0.75 (95% CI: 0.70-0.80), 3.29 (95% CI: 2.64-4.10), 0.25 (95% CI: 0.20-0.31), and 0.85 (95% CI: 0.82-0.88), respectively. Moreover, there were no significant differences between MRI and FDG-PET in sensitivity ( = 0.565), and NLR ( = 0.268), while the specificity ( = 0.006), PLR ( = 0.006), and AUC ( = 0.003) of MRI was higher than FDG-PET.

CONCLUSIONS

MRI might superior than FGD-PET for the prediction of the response of patients with locally advanced RC to NACT.

目的

在本研究中，我们旨在比较磁共振成像（MRI）和氟代脱氧葡萄糖正电子发射断层显像（FDG-PET）对局部晚期直肠癌（RC）患者新辅助放化疗（NACT）反应的预测诊断价值。

方法

系统检索电子数据库，包括PubMed、Embase和Cochrane图书馆，检索截至2021年12月的研究，这些研究调查了MRI和FDG-PET在预测局部晚期RC患者对NACT反应方面的诊断价值。使用QUADAS评估纳入研究的质量。采用双变量广义线性混合模型、随机效应模型和分层回归计算MRI和FDG-PET的合并敏感性、特异性、阳性和阴性似然比（PLR和NLR）以及ROC曲线下面积（AUC）。

结果

本分析共纳入74项研究，招募了4105例局部晚期RC患者。MRI的合并敏感性、特异性、PLR、NLR和AUC分别为0.83（95%CI：0.77-0.88）、0.85（95%CI：0.79-0.89）、5.50（95%CI：4.11-7.35）、0.20（95%CI：0.14-0.27）和0.91（95%CI：0.88-0.93）。FDG-PET的汇总敏感性、特异性、PLR、NLR和AUC分别为0.81（95%CI：0.77-0.85）、0.75（95%CI：0.70-0.80）、3.29（95%CI：2.64-4.10）、0.25（95%CI：0.20-0.31）和0.85（95%CI：0.82-0.88）。此外，MRI和FDG-PET在敏感性（P = 0.565）和NLR（P = 0.268）方面无显著差异，而MRI的特异性（P = 0.006）、PLR（P = 0.006）和AUC（P = 0.003）高于FDG-PET。