常规 MRI、DCE-MRI 和 DWI-MRI 对直肠癌转移性与非转移性淋巴结鉴别诊断价值的系统评价和 Meta 分析研究。
Value of Conventional MRI, DCE-MRI, and DWI-MRI in the Discrimination of Metastatic from Non-Metastatic Lymph Nodes in Rectal Cancer: A Systematic Review and Meta-Analysis Study.
机构信息
MD Radiology, TUMS (Cancer Institute‑ADIR), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Technology of Radiology and Radiotherapy Department, Tehran University of Medical Sciences, International Campus, Tehran, Iran.
出版信息
Asian Pac J Cancer Prev. 2023 Feb 1;24(2):401-410. doi: 10.31557/APJCP.2023.24.2.401.
BACKGROUND
Today, despite many studies on the diagnosis of metastasis to lymph nodes (LNs) in Rectal Cancer (RC), its diagnosis is still very challenging for radiologists. The purpose of the present study was to the assessment of the diagnostic value of conventional MRI, DCE-MRI, and DWI-MRI in the discrimination of metastatic from non-metastatic lymph nodes in RC.
METHODS
In the present meta-analysis study, we surveyed international databases including PubMed, Scopus, Embase, and Science Direct with appropriate keywords. Using the binomial distribution formula, the variance of each study was calculated and the data were analyzed using STATA version 14. Finally, the results of the studies were entered into the random-effects meta-analysis. Also, we used the chi-squared test and I2 index to calculate heterogeneity among studies, and for evaluating publication bias, Funnel plots and Egger tests were used.
RESULTS
31 articles published between 2005 and 2021, comprising 2517 patients were included in the present study. The sensitivity and specificity of DCE-MRI were 83% (74% to 80%), and 86% (80% to 93%), respectively with PPV 84% (76% to 89%) and NPV 88% (79% to 95%). Also, the sensitivity and specificity of DWI-MRI were 81% (74% to 88%), and 74% (78% to 91%), respectively with PPV 63% (54% to 74%), NPV 85% (77% to 93%), AUC 80 % (75% to 86%) and accuracy 82% (75% to 88%). For conventional MRI, the sensitivity 74% (67% to 80%), specificity 77% (71% to 83%), PPV 62% (48% to 69%), NPV 70% (62% to 77%), AUC 78% (72% to 83%) and 71% accuracy (68% to 78%) was obtained.
CONCLUSION
Based on our finding DCE-MRI is the most suitable technique for the discrimination of metastatic lymph nodes in rectal cancer.
背景
尽管目前有许多关于直肠癌（RC）淋巴结转移诊断的研究，但对于放射科医生来说，其诊断仍然极具挑战性。本研究旨在评估常规 MRI、DCE-MRI 和 DWI-MRI 对 RC 中转移性与非转移性淋巴结的鉴别诊断价值。
方法
在本次荟萃分析研究中，我们使用适当的关键词检索了国际数据库，包括 PubMed、Scopus、Embase 和 Science Direct。使用二项式分布公式计算每个研究的方差，并使用 STATA 版本 14 进行数据分析。最后，将研究结果输入到随机效应荟萃分析中。我们还使用卡方检验和 I2 指数来计算研究之间的异质性，并使用漏斗图和 Egger 检验来评估发表偏倚。
结果
本研究共纳入 2005 年至 2021 年期间发表的 31 篇文章，共包含 2517 例患者。DCE-MRI 的敏感性和特异性分别为 83%（74%至 80%）和 86%（80%至 93%），PPV 分别为 84%（76%至 89%）和 NPV 分别为 88%（79%至 95%）。DWI-MRI 的敏感性和特异性分别为 81%（74%至 88%）和 74%（78%至 91%），PPV 分别为 63%（54%至 74%）、NPV 分别为 85%（77%至 93%）、AUC 为 80%（75%至 86%）和准确率分别为 82%（75%至 88%）。对于常规 MRI，获得的敏感性为 74%（67%至 80%）、特异性为 77%（71%至 83%）、PPV 为 62%（48%至 69%）、NPV 为 70%（62%至 77%）、AUC 为 78%（72%至 83%）和准确率为 71%（68%至 78%）。
结论
根据我们的发现，DCE-MRI 是鉴别 RC 中转移性淋巴结的最佳技术。
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