双时相^(18)F-FDGPET/CT对肺结节诊断价值的Meta分析  

Meta-analysis of Dual-time-point ^(18)F-FDG PET/CT in Diagnosis of Pulmonary Nodules

作　　者：沈国华[1] 贾志云[1] 周绿漪[1] 王乔[1] 邓候富[1] 

机构地区：[1]四川大学华西医院核医学科,四川成都610041

出　　处：《中国医学影像学杂志》2014年第7期529-534,共6页Chinese Journal of Medical Imaging

基　　金：国家自然科学基金项目(81171456;81271532/H1801)

摘　　要：目的双时相PET/CT鉴别诊断肺良、恶性结节的灵敏度和特异度目前尚无明确的证据,本研究系统评价双时相18F-FDG PET/CT对肺结节的诊断价值。资料与方法计算机检索PubMed、Web of Knowledge、Cochrane Library、Ovid、EMBASE、中国知网、维普、万方数据库,检索并筛选出关于双时相PET/CT鉴别诊断肺良、恶性结节的研究,提取数据和资料,并根据QUADAS条目评估文献质量,计算敏感度合并、特异度合并、阳性似然比合并、阴性似然比合并、诊断优势比合并;并绘制汇总受试者工作特征曲线,计算曲线下面积(AUC)和Q值。结果共纳入23篇文献,包括1366个病灶。Meta分析结果显示:敏感度合并为0.82(95%CI0.79~0.85,I2=79.1%),特异度合并为0.73(95%CI 0.70~0.77,I2=84.2%),阳性似然比合并、阴性似然比合并分别为2.60(95%CI 1.84~3.67)和0.24(95%CI 0.16~0.36),诊断优势比合并为12.12(95%CI 6.23~23.57),AUC=0.8538,Q*=0.7848。结论双时相PET/CT对肺结节的诊断效能较高,但与常规PET/CT相近,没有明显的优势,需要更多高质量的研究来探讨其临床应用潜能。Purpose The sensitivity and specificity of dual-time-point PET/CT for differential diagnosis of pulmonary nodules have not yet been proven.This study aims to evaluate the diagnostic value of dual-time-point 18F-FDG PET/CT in the diagnosis of pulmonary nodules.Materials and Methods The PubMed,Web of Knowledge,the Cochrane Library,Ovid,EMBASE and such Chinese databases as CNKI,VIP and Wanfang Data were screened to find out articles about using dual-time-point 18F-FDG PET/CT to differentiate pulmonary nodules.The QUADAS tool was used to assess the quality of study methodology.The indexes like summary sensitivity,summary specificity,summary diagnostic odds ratios （DOR）,and summary positive likelihood ratios （LR ＋） and negative likelihood ratios （LR-） were calculated.Summary receiver-operating characteristic （SROC） curves were also drawn to obtain the area under curve （AUC） and Q value.Results A total of 23 articles were included,involving 1366 lesions.The Meta analysis showed that the summary sensitivity of dual-time-point PET/CT was 0.82 （95％ CI0.79-0.85,I2=79.1％）,the summary specificity was 0.73 （95％ CI 0.70-0.77,I2=84.2％）,the summary LR ＋ and LR-were 2.60 （95％ CI 1.84-3.67） and 0.24 （95％ CI 0.16-0.36） respectively,and DOR was 12.12 （95％ CI 6.23-23.57）.The AUC was 0.8538 and Q＊ value was 0.7848.Conclusion Dual-time-point 18F-FDG PET/CT has similar sensitivity and specificity with single-time-point PET/CT in the diagnosis of pulmonary nodules.Further high quality research is required to explore the potential value of dual-time-point 18F-FDG PET/CT.

关 键 词：肺肿瘤 结节病 肺 正电子发射断层显像术 体层摄影术 X线计算机 双时相显像 氟脱氧葡萄糖F18 诊断 鉴别 META分析 

分 类 号：R734.2[医药卫生—肿瘤] R730.42[医药卫生—临床医学]