Department of Thyroid Surgery, West China Hospital, Sichuan University and .
Laboratory of Thyroid and Parathyroid Disease, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China.
Nucl Med Commun. 2023 Dec 1;44(12):1114-1125. doi: 10.1097/MNM.0000000000001773. Epub 2023 Sep 29.
Detecting medullary thyroid carcinoma (MTC) metastatic lesions accurately is still a challenge for clinicians. PET/computed tomography (PET/CT) seems to be the most effective method in recent years. However, the sensitivity of each radiopharmaceutical varies greatly in different metastatic sites. We aim to investigate and compare five novel and common PET or PET/CT radiopharmaceutical sensitivities at the four most frequent metastatic sites by network meta-analysis.
We searched for studies evaluating PET/CT radiopharmaceutical sensitivities at different metastatic sites in PubMed, Web of Science, Embase, and Cochrane Library. The risk bias was analyzed, and publication bias was accessed by funnel plot asymmetry tests. We performed both global inconsistency and local inconsistency tests by evaluating the agreement between direct and indirect comparisons. Then, we made pairwise meta-analyses and network meta-analyses for each metastatic site. Finally, we performed the surface under the cumulative ranking curves (SUCRA) and calculated the SUCRA values to rank the probability of each radiopharmaceutical being the most sensitive method.
In our results, 243 patients from 9 clinical studies which accessed sensitivities of different radiopharmaceuticals in MTC metastatic sites were included. For lymph nodes and liver, TF2/ 68 Ga-SSM288 showed the highest SUCRA values (0.974 in lymph nodes, 0.979 in liver). The SUCRA values for 18 F-DOPA and 68 Ga-SSA for bone metastatic lesions were nearly identical (0.301 and 0.319, respectively) and were higher than the other three radiopharmaceuticals. For lung lesions, 11 C-methionine had the highest SUCRA value (0.412).
TF2/ 68 Ga-SSM288 had the best sensitivity in lymph nodes and liver lesions. 11 C-methionine was most sensitive in lung lesions. While 18 F-DOPA and 68 Ga-SSA had familiar sensitivities to be the best two radiopharmaceuticals.
准确检测甲状腺髓样癌（MTC）转移病灶仍然是临床医生面临的挑战。PET/计算机断层扫描（PET/CT）似乎是近年来最有效的方法。然而，每种放射性药物在不同转移部位的灵敏度差异很大。我们旨在通过网络荟萃分析研究并比较四种最常见的转移部位的五种新型和常见的 PET 或 PET/CT 放射性药物的灵敏度。
我们在 PubMed、Web of Science、Embase 和 Cochrane Library 中搜索评估不同转移部位 PET/CT 放射性药物灵敏度的研究。通过漏斗图不对称检验分析风险偏倚，并评估发表偏倚。我们通过评估直接和间接比较之间的一致性来进行全局和局部不一致性检验。然后，我们对每个转移部位进行了成对的荟萃分析和网络荟萃分析。最后，我们进行了累积排序曲线下面积（SUCRA）分析，并计算了 SUCRA 值来对每种放射性药物作为最敏感方法的概率进行排名。
在我们的研究结果中，纳入了来自 9 项临床研究的 243 名患者，这些研究评估了 MTC 转移部位不同放射性药物的灵敏度。对于淋巴结和肝脏，TF2/68 Ga-SSM288 的 SUCRA 值最高（淋巴结为 0.974，肝脏为 0.979）。18 F-DOPA 和 68 Ga-SSA 对骨转移病灶的 SUCRA 值几乎相同（分别为 0.301 和 0.319），高于其他三种放射性药物。对于肺病变，11 C-蛋氨酸的 SUCRA 值最高（0.412）。
TF2/68 Ga-SSM288 在淋巴结和肝脏病变中具有最佳的灵敏度。11 C-蛋氨酸在肺病变中最敏感。而 18 F-DOPA 和 68 Ga-SSA 具有相似的灵敏度，是两种最佳的放射性药物。
