Department of Nuclear Medicine, TheAffilliated Hospital of Southwest Medical University. Luzhou, Sichuan, 646000, PR China.
Hell J Nucl Med. 2023 May-Aug;26(2):123-131. doi: 10.1967/s002449912575. Epub 2023 Aug 4.
To conduct a meta-analysis of the diagnostic efficacy of fluorine-18-fluorodeoxyglucose (F-FDG) and gallium-68-labeled fibroblast-activation protein inhibitor (Ga-FAPI) positron emission tomography/computed tomography (PET/CT) for primary liver cancer based on existing clinical evidence.
Meta-analysis was carried out according to PRISMA reporting specification. The clinical studies in PubMed/Medline, Embase and the Cochrane Library database were retrieved from the establishment to September 2022. Two researchers independently conducted literature screening and data extraction, evaluated the risk of bias according to QUADAS-2, conducted meta-analysis using Meta Disc 1.4 and Stata15.1 software, and calculated the summarized sensitivity (SEN), specificity (SPE), positive likelihood ratio (+LR), negative likelihood ratio (-LR), and diagnostic odds ratio (DOR). The diagnostic performance of F-FDG PET/CT and Ga-FAPI PET/CT for primary liver cancer was compared using summarized receiver operating characteristic (SROC) curve and area under curve (AUC).
Four original studies on F-FDG PET/CT and Ga-FAPI PET/CT in the diagnosis of primary liver cancer were included, including 159 intrahepatic lesions in 106 patients. Taking lesions as a unit, in four original studies, the pooled results of F-FDG PET/CT diagnosis of primary liver cancer were Sen=0.5 (95% CI:95% CI: 0.41-0.59), Spe=0.87 (95% CI: 0.52-0.98), AUC=0.58 (95% CI:0.53-0.62); The pooled results of Ga-FAPI PET/CT in the diagnosis of primary liver cancer, Sen=0.5 (95% CI: 0.41-0.59), Spe=0.87 (95%CI:0.52-0.98), AUC=0.58 (95% CI:0.53-0.62). Besides, the Sen of Ga-FAPI PET/CT in the diagnosis of primary liver cancer was higher than that of F-FDG PET/CT (Z=2.323, P=0.02), the difference was statistically significant.
Gallium-68-FAPI PET/CT is a promising tool. Compared with F-FDG, Ga-FAPI has higher sensitivity to detect more lesions in primary liver cancer and metastatic lesions, and has high performance in the diagnosis of primary liver cancer.
基于现有临床证据，对氟-18-氟代脱氧葡萄糖（F-FDG）和镓-68 标记的成纤维细胞激活蛋白抑制剂（Ga-FAPI）正电子发射断层扫描/计算机断层扫描（PET/CT）在原发性肝癌中的诊断效能进行荟萃分析。
根据 PRISMA 报告规范进行荟萃分析。从建立到 2022 年 9 月，检索了 PubMed/Medline、Embase 和 Cochrane Library 数据库中的临床研究。两位研究人员独立进行文献筛选和数据提取，根据 QUADAS-2 评估偏倚风险，使用 Meta Disc 1.4 和 Stata15.1 软件进行荟萃分析，并计算汇总敏感性（SEN）、特异性（SPE）、阳性似然比（+LR）、阴性似然比（-LR）和诊断比值比（DOR）。使用汇总受试者工作特征（SROC）曲线和曲线下面积（AUC）比较 F-FDG PET/CT 和 Ga-FAPI PET/CT 对原发性肝癌的诊断性能。
纳入了 4 项关于 F-FDG PET/CT 和 Ga-FAPI PET/CT 诊断原发性肝癌的原始研究，共纳入了 106 名患者的 159 个肝内病变。以病变为单位，在 4 项原始研究中，F-FDG PET/CT 诊断原发性肝癌的汇总结果为 Sen=0.5（95%CI：0.41-0.59），Spe=0.87（95%CI：0.52-0.98），AUC=0.58（95%CI：0.53-0.62）；Ga-FAPI PET/CT 诊断原发性肝癌的汇总结果为 Sen=0.5（95%CI：0.41-0.59），Spe=0.87（95%CI：0.52-0.98），AUC=0.58（95%CI：0.53-0.62）。此外，Ga-FAPI PET/CT 诊断原发性肝癌的灵敏度高于 F-FDG PET/CT（Z=2.323，P=0.02），差异具有统计学意义。
镓-68-FAPI PET/CT 是一种很有前途的工具。与 F-FDG 相比，Ga-FAPI 对原发性肝癌和转移性病变的检测具有更高的灵敏度，在原发性肝癌的诊断中具有较高的性能。
