Department of Medical Imaging, Jiangsu Vocational College of Medicine, Yancheng, China.
Department of Burn and Plastic Surgery, Affiliate Huaihai Hospital of Xuzhou Medical University, Xuzhou, China.
Radiol Med. 2024 Jan;129(1):70-79. doi: 10.1007/s11547-023-01742-2. Epub 2023 Oct 30.
This study aimed to assess the diagnostic performance of NI-RADS for the prediction of recurrence in patients treated for Head and Neck Squamous Cell Carcinoma (HNSCC).
A literature search was conducted using various databases to identify relevant articles published from June 2016 onwards. We included studies reporting the diagnostic accuracy of NI-RADS in distinguishing recurrence in patients undergoing imaging surveillance, with pathologic results and/or follow-up as the reference standard. Summary estimates of diagnostic accuracy in terms of sensitivity, specificity, positive likelihood ratio (LR +), negative likelihood ratio (LR -), and diagnostic odds ratio (DOR) were calculated with the hierarchical summary receiver operating characteristic (HSROC) model. Meta-regression and subgroup analyses were conducted to investigate different clinical settings. Study quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.
A total of 12 studies were included in the current meta-analysis. The pooled sensitivity and specificity were 0.69 (95% CI 0.59-0.79) and 0.94 (95% CI 0.89-0.97), respectively. For the primary site, the pooled summary estimates were 0.67 (95% CI 0.53-0.78) and 0.95 (95% CI 0.90-0.97), for the nodal sites were 0.64 (95% CI 0.44-0.80) and 0.99 (95% CI 0.98-0.99), respectively. The recurrence rate for NI-RADS categories 1-3 was 0.03 (95% CI 0.02-0.05), 0.13 (95% CI 0.10-0.15), and 0.77 (95% CI 0.73-0.81). Meta-regression revealed that the type of analysis (per person vs. per site) and number of sites (≤ 200 vs. > 200) were significant factors associated with heterogeneity.
NI-RADS demonstrated high specificity but moderate sensitivity in patients after treatment for HNSCC. Summary estimates showed a significantly higher malignancy rate for NI-RADS category 3 compared to category 2.
本研究旨在评估 NI-RADS 对治疗头颈部鳞状细胞癌（HNSCC）后患者复发的预测的诊断性能。
使用各种数据库进行文献检索，以确定自 2016 年 6 月以来发表的相关文章。我们纳入了报告在接受影像学监测的患者中，以病理结果和/或随访为参考标准的 NI-RADS 诊断准确性的研究。使用分层汇总受试者工作特征（HSROC）模型计算诊断准确性的汇总估计值，包括敏感度、特异度、阳性似然比（LR+）、阴性似然比（LR-）和诊断比值比（DOR）。Meta 回归和亚组分析用于研究不同的临床环境。使用诊断准确性研究质量评估工具 2（QUADAS-2）评估研究质量。
本 meta 分析共纳入 12 项研究。汇总的敏感度和特异度分别为 0.69（95%置信区间 0.59-0.79）和 0.94（95%置信区间 0.89-0.97）。对于原发部位，汇总的总结估计值分别为 0.67（95%置信区间 0.53-0.78）和 0.95（95%置信区间 0.90-0.97），对于淋巴结部位，汇总的总结估计值分别为 0.64（95%置信区间 0.44-0.80）和 0.99（95%置信区间 0.98-0.99）。NI-RADS 类别 1-3 的复发率分别为 0.03（95%置信区间 0.02-0.05）、0.13（95%置信区间 0.10-0.15）和 0.77（95%置信区间 0.73-0.81）。Meta 回归显示，分析类型（每人 vs. 每部位）和部位数量（≤200 vs. >200）是与异质性相关的显著因素。
NI-RADS 对头颈部鳞状细胞癌（HNSCC）治疗后患者具有高特异性但中度敏感度。汇总估计值表明，与类别 2 相比，类别 3 的恶性程度明显更高。
