^(18)F-FDG PET/CT与^(99)Tc^m-MDP骨显像诊断肿瘤骨转移价值的Meta分析  

Diagnosis Value of ^(18)FDG-PET/CT and ^(99)Tc^m-MDP Bone Scan in Bone Metastases of Tumors:A Meta-analysis

作　　者：谢纪宝[1] 陈江涛[1] 宋兴华[1] 

机构地区：[1]新疆医科大学第一附属医院骨科中心,乌鲁木齐830054

出　　处：《中国循证医学杂志》2011年第6期655-660,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的评价18F-FDG PET/CT与99Tcm-MDP骨显像对肿瘤骨转移早期诊断的价值。方法计算机检索MEDLINE、PubMend、EMbase、Ovid、Cochrane Library数据库,检索时间截至2010年,搜集18F-FDG PET/CT与99Tcm-MDP骨显像诊断恶性肿瘤骨转移的文献。由3位研究者根据纳入与排除标准独立筛选文献、提取资料和评价质量后,采用MetaDisc软件进行Meta分析,计算合并敏感性、特异性、诊断优势比(DOR),并绘制SROC曲线,计算曲线下面积(AUC)与Q*。结果最终纳入5个研究。Meta分析结果显示:18F-FDG PET/CT与99Tcm-MDP骨显像在诊断肿瘤骨转移的敏感性合并分别为0.95[95%CI(0.90,0.97)]和0.77[95%CI(0.71,0.83)],特异性合并分别为0.98[95%CI(0.97,0.99)]和0.90[95%CI(0.88,0.92)],DOR合并分别为602.81[95%CI(214.07,1 697.51)]和41.37[95%CI(8.15,210.05)];SROC AUC与Q*分别为0.984 2、0.901 7和0.945 4、0.833 1。结论应用18F-FDG PET/CT早期诊断肿瘤骨转移明显优于99Tcm-MDP骨显像。To use meta-analysis method to assess the efficacy of fluorine-18fluorode-oxyglucose posi tron emission tomography/computed tomography （PET/CT） （18F-FDG-PET/CT） scan and 99Tcm-methylene diphosphonate （99Tcrn-MDP） bone scan （BS） on early diagnosis of bone metastases of cancer. Methods Computer-based retrieval was conducted on MEDLINE, PubMed, EMbase, Ovid, and The Cochrane Library （from their establishment to 2010） to search reports about diagnosing bone metastases of cancer with 18FDG-PET/CT and 99Tcm-MDP Bone Scan. Three reviewers independently selected the studies according to the inclusion and exclusion criteria, collected the data, and evaluated the quality. MetaDisc software was adopted to conduct meta-analyses. The pooled sensitivity, specificity, and diagnostic odds ratio （DOR） were calculated, the summary receiving operating characteristic （SROC） curve was drawn, and the areas under the curve （AUC） and Q＊ were measured. Results Five studies were included. The results ofmeta-analyses showed that the pooled sensitivity of 18FDG-PET/CT and 99Tcm-MDP BS in the diagnosis of bone metastases was 0.95 （95%CI 0.90 to 0.97） and 0.77 （95%CI 0.71 to 0.83）, respectively; the pooled specificity was 0.98 （95%CI 0.97 to 0.99） and 0.90 （95%CI 0.88 to 0.92）, respectively; the pooled DOR was 602.81 （95%CI 214.07 to 1697.51） and 41.37 （95%CI 8.15 to 210.05）, respectively; the AUC was 0.984 2 and 0.901 7, respectively; and the Q＊ index was 0.945 4 and 0.833 1, respectively. Conclusion The 18F-FDG PET/CT is more effective than the 99Tcm-MDP bone scan in the early diagnosis of bone metastases in cancer

关 键 词：骨转移瘤 正电子发射体层摄影/断层扫描术(PET/CT) 核素骨扫描 META分析 系统评价 

分 类 号：R817.4[医药卫生—影像医学与核医学] R738[医药卫生—放射医学]