Mirshahvalad Seyed Ali, Zamani-Siahkali Nazanin, Pirich Christian, Beheshti Mohsen
Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria.
Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital & Women's College Hospital, University Medical Imaging Toronto (UMIT), University of Toronto, Toronto, ON M5G 2N2, Canada.
Cancers (Basel). 2024 Apr 28;16(9):1712. doi: 10.3390/cancers16091712.
In this systematic review and meta-analysis (PRISMA-compliant), we tried to investigate diagnostic and prognostic values of F-FDG PET in uveal melanoma. A systematic search was conducted on the main medical literature databases to include studies that evaluated F-FDG PET as the imaging modality to evaluate patients with uveal melanoma. Overall, 27 studies were included. Twelve had data about the detection rate of F-FDG PET in primary intra-ocular tumours. The pooled sensitivity was 45% (95%CI: 41-50%). Furthermore, studies showed that the larger the primary tumour, the higher its uptake. Among the included studies, 13 assessed F-FDG PET in detecting metastasis. The pooled sensitivity and specificity were 96% (95%CI: 81-99%) and 100% (95%CI: 94-100%), respectively. Regarding liver metastasis, they were 95% (95%CI: 79-99%) and 100% (95%CI: 91-100%), respectively. Noteworthy, the level of F-FDG uptake was a strong predictor of patient survival. Lastly, F-FDG PET could characterise lesions from the histopathology perspective, distinguishing high-risk from low-risk diseases. Overall, although not reliable in detecting primary intra-ocular tumours, F-FDG PET is highly accurate for diagnosing metastatic uveal melanomas. It can also be a highly valuable modality in terms of patient prognostication. Thus, F-FDG PET can be recommended in patients diagnosed with uveal melanoma to enhance decision-making and patient management.
在这项符合PRISMA标准的系统评价和荟萃分析中，我们试图研究F-FDG PET在葡萄膜黑色素瘤中的诊断和预后价值。对主要医学文献数据库进行了系统检索，以纳入评估F-FDG PET作为评估葡萄膜黑色素瘤患者的成像方式的研究。总体而言，纳入了27项研究。其中12项有关于F-FDG PET在原发性眼内肿瘤中的检出率的数据。汇总敏感性为45%（95%CI：41-50%）。此外，研究表明原发性肿瘤越大，其摄取越高。在纳入的研究中，13项评估了F-FDG PET在检测转移方面的情况。汇总敏感性和特异性分别为96%（95%CI：81-99%）和100%（95%CI：94-100%）。对于肝转移，分别为95%（95%CI：79-99%）和100%（95%CI：91-100%）。值得注意的是，F-FDG摄取水平是患者生存的有力预测指标。最后，F-FDG PET可以从组织病理学角度对病变进行特征化，区分高危和低危疾病。总体而言，尽管F-FDG PET在检测原发性眼内肿瘤方面不可靠，但对于诊断转移性葡萄膜黑色素瘤高度准确。在患者预后方面它也可能是一种非常有价值的检查方法。因此，对于诊断为葡萄膜黑色素瘤的患者，可推荐使用F-FDG PET以加强决策制定和患者管理。
