~(18)F-FDG PET/CT与DWI-MRI判断鼻咽癌放疗后残留/复发价值的Meta分析
|
摘要
目的对比~(18)F-FDG PET/CT(PET/CT)和扩散加权成像(DWI)判断鼻咽癌放疗后局部残留/复发的价值。方法检索PubMed、Cochrane Library、Embase、中国生物医学文献数据库、中国学术期刊全文数据库,获取相关文献,末次检索时间为2017年7月。两名研究者独立筛选文献和提取数据,并根据诊断准确性研究质量评价工具(QUADAS-2)标准评价文献质量,通过STATA15.0软件计算出PET/CT和DWI的合并敏感度、特异度、汇总受试者工作特征(SROC)曲线和Q*值。结果 11项PET/CT和9项DWI研究纳入分析,PET/CT与DWI的汇总的敏感度分别为92%(95%CI:0.87～0.95)和88%(95%CI:0.83～0.92),汇总的特异度分别为85%(95%CI:0.75～0.91)和87%(95%CI:0.80～0.92),受试者工作曲线(SROC)曲线下面积均为0.94,比较差异无统计学意义(P>0.05),Q*值分别为0.89、0.87。结论 PET/CT与DWI在诊断鼻咽癌放疗后残留/复发的诊断价值无明显区别。
Objective To compare the value of ~(18)F-FDG PET/CT(PET/CT)with diffusion weighted imaging(DWI)in detecting local residue/recurrent of nasopharyngeal carcinoma after radiotherapy.Methods PubMed,Cochrane Library,Embase,Sinomed and China Jornal Full-text Database(CJFB)were searched,and the last retrieval time was July 2017.Two researchers independently screened the literature and extracted data,and methodological quality was assessed using QUADAS-2.Pooled sensitivity,pooled specificity,summary receiver operating characteristic(SROC)curves and Q * value were obtained using STATA 15.0 software.Results A total of 11 PET/CT and 9 DWI studies were included in the Meta-analysis.The pooled sensitivity for PET/CT and DWI-MRI were 92%(95%CI:0.87-0.95)and 88%(95%CI:0.83-0.92).The pooled specificity were 85%(95%CI:0.75-0.91)and 87%(95%CI:0.79-0.92).Area under SROC curve of PET/CT and DWI were 0.94 and 0.94(P>0.05).The Q* value for PET/CT and DWI-MRI were 0.89 and0.87.Conclusion There were no significant differences between PET/CT and DWI in detecting local residual/recurrent nasopharyngeal carcinoma after radiotherapy.
Objective To compare the value of ~(18)F-FDG PET/CT(PET/CT)with diffusion weighted imaging(DWI)in detecting local residue/recurrent of nasopharyngeal carcinoma after radiotherapy.Methods PubMed,Cochrane Library,Embase,Sinomed and China Jornal Full-text Database(CJFB)were searched,and the last retrieval time was July 2017.Two researchers independently screened the literature and extracted data,and methodological quality was assessed using QUADAS-2.Pooled sensitivity,pooled specificity,summary receiver operating characteristic(SROC)curves and Q * value were obtained using STATA 15.0 software.Results A total of 11 PET/CT and 9 DWI studies were included in the Meta-analysis.The pooled sensitivity for PET/CT and DWI-MRI were 92%(95%CI:0.87-0.95)and 88%(95%CI:0.83-0.92).The pooled specificity were 85%(95%CI:0.75-0.91)and 87%(95%CI:0.79-0.92).Area under SROC curve of PET/CT and DWI were 0.94 and 0.94(P>0.05).The Q* value for PET/CT and DWI-MRI were 0.89 and0.87.Conclusion There were no significant differences between PET/CT and DWI in detecting local residual/recurrent nasopharyngeal carcinoma after radiotherapy.
引文
[1]SABA N F,SALAMA J K,BEITLER J J,et al.ACR Appropriateness criteria for nasopharyngeal carcinoma[J].Head Neck,2016,38(7):979-986.
[2]JIN G,SU D,LIU L,et al.The accuracy of computed tomographic perfusion in detecting recurrent nasopharyngeal carcinoma after radiation therapy[J].Comput Assist Tomogr,2011,35(1):26-30.
[3]LAI V,KHONG P L.Updates on MR imaging and 18F-FDG PET/CT imaging in nasopharyngeal carcinoma[J].Oral Oncol,2014,50(6):539-548.
[4]WEI J,PEI S,ZHU X.Comparison of 18F-FDG PET/CT,MRI and SPECT in the diagnosis of local residual/recurrent nasopharyngeal carcinoma:a meta-analysis[J].Oral Oncol,2015,51(2):11-17.
[5]徐国增,朱小东,李明耀.FDG PET或PET-CT与MRI判断鼻咽癌放疗后局部残留或复发价值荟萃分析[J].中华放射肿瘤学杂志,2010,19(5):391-395.
[6]庞青松,王静,戴东,等.18 FDG PET-CT在鼻咽癌放疗后的应用价值[J].中华放射肿瘤学杂志,2007,16(6):411-415.
[7]李卫红,黄晓明,曾亮,等.脱氧葡萄糖-正电子发射断层显像在鼻咽癌诊断和放疗后肿瘤残留或复发判定中的价值[J].中华耳鼻咽喉头颈外科杂志,2007,42(1):65-66.
[8]肖勇,李奕钊,郭晓君,等.PET/CT显像在判断鼻咽癌放疗后病灶残留或复发中的价值[J].广东医学,2007,28(7):1140-1141.
[9]COMORETTO M,BALESTRERI L,BORSATTI E,et al.Detection and restaging of residual and/or recurrent nasopharyngeal carcinoma after chemotherapy and radiation therapy:comparison of MR imaging and FDG PET/CT.[J].Radio,2008,249(1):203-211.
[10]何承诚,瞿炳刚,司勇锋,等.鼻咽癌治疗后FDG PET/CT与CT诊断的对比分析[J/CD].中华临床医师杂志(电子版),2010,4(11):170-171.
[11]张华,李国文,谢爱民,等.PET-CT和MRI在诊断鼻咽癌放疗后复发中的价值[J].现代肿瘤医学,2010,18(11):2123-2127.
[12]王枫,李亚敏,孟汶,等.18F-FDG PET/CT在复发鼻咽癌诊断中的作用[J].中国实验诊断学,2014,18(6):1009-1011.
[13]陆英英,杜晓东.18F-FDG PET-CT显像在诊断鼻咽癌放疗后早期复发的应用价值[J].江苏医药,2014,40(8):915-917.
[14]廖凤翔,吴梨兵,骆柘璜,等.18 F-FDG PET/CT对鼻咽癌疗效评估的价值分析[J].江西医药,2015,50(12):1351-1354.
[15]李建鹏,邹玉坚,毕伟,等.动态增强MRI和18 F-FDG-PET/CT对鼻咽癌放疗后复发与纤维化的诊断价值[J].影像诊断与介入放射学,2015,24(6):471-475.
[16]陈露斯,张宁,王颖,等.氟代脱氧葡萄糖PET-CT联合病理活检对鼻咽癌放疗后残存肿瘤的诊断价值[J].中华肿瘤杂志,2015,37(3):213-215.
[17]张兰芳,何侠,郭震,等.扩散加权成像在鉴别鼻咽癌局部复发和放疗后改变中的应用[J].肿瘤学杂志,2011,17(11):839-843.
[18]周定中,曹苏娟,李庆,等.磁共振扩散加权成像在鼻咽癌放疗后局部复发诊断中的应用[J].湘南学院学报(医学版),2012,14(2):25-27.
[19]钟贻洪,李金高,钟俊远,等.磁共振表观扩散系数对鼻咽癌放疗后复发与纤维化的鉴别诊断价值[J].实用癌症杂志,2013,28(3):288-291.
[20]林蒙,余小多,赵燕风,等.扩散加权成像表观扩散系数预测鼻咽癌同步放化疗疗效[J].中国医学影像技术,2014,30(7):986-990.
[21]王琛,苏丹柯,刘丽东,等.MR扩散加权成像对鼻咽癌患者局部复发的诊断价值[J].中华放射学杂志,2014,48(6):476-479.
[22]何汇朗,刘辉明,许森奎,等.MR扩散加权成像预测鼻咽癌放疗预后的价值[J].中华放射学杂志,2017,51(1):13-17.
[23]郭笑寒,孔祥林,田兴仓,等.扩散加权成像对鼻咽癌放化疗疗效的预测价值[J].临床放射学杂志,2017,36(1):28-33.
[24]SIMO R,ROBINSON M,LEI M,et al.Nasopharyngeal carcinoma:United Kingdom National Multidisciplinary Guidelines[J].J Laryngol Otol,2016,130(2):S97-103.
[25]MOHANDAS A,MARCUS C,KANG H,et al.FDGPET/CT in the management of nasopharyngeal carcinoma.[J].Am J Roentgenol,2014,203(2):146-157.
[26]ZHOU H,ZHOU Y,LI L.Meta-analysis of 18F-FDGPETCT for diagnosis of residual/recurrent nasopharyngeal carcinoma after radiotherapy[J].Eur Nucl Med Mol I,2015,42(1):S606-607.
[27]陈韵彬,毛瑜,潘建基,等.鼻咽癌弥散加权成像临床研究[J].中华放射肿瘤学杂志,2009,18(2):88-91.
[28]侯毅斌,王忠富,陈国硕,等.中短期鼻咽癌放疗随访中磁共振扩散加权成像的应用价值[J].中国CT和MRI杂志,2015,13(6):8-9.
[29]徐继飞,王凡.磁共振成像在鼻咽癌放射治疗中的应用[J].国际肿瘤学杂志,2012,39(2):127-130.
[30]YILDIRIM I O,EKICI K,DOGAN M,et al.Can diffusion weighted magnetic resonance imaging(DW-MRI)be an alternative to 18F-FDG PET-CT(18 F-fluorodeoxyglucose positron emission tomography)in nasopharyngeal cancers?[J].Biomed Res,2017,28(9):4255-4260.
[31]YEN R F,HUNG R L,PAN M H,et al.18-fluoro-2-deoxyglucose positron emission tomography in detecting residual/recurrent nasopharyngeal carcinomas and comparison with magnetic resonance imaging[J].Cancer,2003,98(2):283-287.
[32]马美,杜晓东.18氟-脱氧葡萄糖正电子发射断层扫描显像对鼻咽癌复发早期的诊断价值[J].国际耳鼻咽喉头颈外科杂志,2013,37(1):51-53.
[2]JIN G,SU D,LIU L,et al.The accuracy of computed tomographic perfusion in detecting recurrent nasopharyngeal carcinoma after radiation therapy[J].Comput Assist Tomogr,2011,35(1):26-30.
[3]LAI V,KHONG P L.Updates on MR imaging and 18F-FDG PET/CT imaging in nasopharyngeal carcinoma[J].Oral Oncol,2014,50(6):539-548.
[4]WEI J,PEI S,ZHU X.Comparison of 18F-FDG PET/CT,MRI and SPECT in the diagnosis of local residual/recurrent nasopharyngeal carcinoma:a meta-analysis[J].Oral Oncol,2015,51(2):11-17.
[5]徐国增,朱小东,李明耀.FDG PET或PET-CT与MRI判断鼻咽癌放疗后局部残留或复发价值荟萃分析[J].中华放射肿瘤学杂志,2010,19(5):391-395.
[6]庞青松,王静,戴东,等.18 FDG PET-CT在鼻咽癌放疗后的应用价值[J].中华放射肿瘤学杂志,2007,16(6):411-415.
[7]李卫红,黄晓明,曾亮,等.脱氧葡萄糖-正电子发射断层显像在鼻咽癌诊断和放疗后肿瘤残留或复发判定中的价值[J].中华耳鼻咽喉头颈外科杂志,2007,42(1):65-66.
[8]肖勇,李奕钊,郭晓君,等.PET/CT显像在判断鼻咽癌放疗后病灶残留或复发中的价值[J].广东医学,2007,28(7):1140-1141.
[9]COMORETTO M,BALESTRERI L,BORSATTI E,et al.Detection and restaging of residual and/or recurrent nasopharyngeal carcinoma after chemotherapy and radiation therapy:comparison of MR imaging and FDG PET/CT.[J].Radio,2008,249(1):203-211.
[10]何承诚,瞿炳刚,司勇锋,等.鼻咽癌治疗后FDG PET/CT与CT诊断的对比分析[J/CD].中华临床医师杂志(电子版),2010,4(11):170-171.
[11]张华,李国文,谢爱民,等.PET-CT和MRI在诊断鼻咽癌放疗后复发中的价值[J].现代肿瘤医学,2010,18(11):2123-2127.
[12]王枫,李亚敏,孟汶,等.18F-FDG PET/CT在复发鼻咽癌诊断中的作用[J].中国实验诊断学,2014,18(6):1009-1011.
[13]陆英英,杜晓东.18F-FDG PET-CT显像在诊断鼻咽癌放疗后早期复发的应用价值[J].江苏医药,2014,40(8):915-917.
[14]廖凤翔,吴梨兵,骆柘璜,等.18 F-FDG PET/CT对鼻咽癌疗效评估的价值分析[J].江西医药,2015,50(12):1351-1354.
[15]李建鹏,邹玉坚,毕伟,等.动态增强MRI和18 F-FDG-PET/CT对鼻咽癌放疗后复发与纤维化的诊断价值[J].影像诊断与介入放射学,2015,24(6):471-475.
[16]陈露斯,张宁,王颖,等.氟代脱氧葡萄糖PET-CT联合病理活检对鼻咽癌放疗后残存肿瘤的诊断价值[J].中华肿瘤杂志,2015,37(3):213-215.
[17]张兰芳,何侠,郭震,等.扩散加权成像在鉴别鼻咽癌局部复发和放疗后改变中的应用[J].肿瘤学杂志,2011,17(11):839-843.
[18]周定中,曹苏娟,李庆,等.磁共振扩散加权成像在鼻咽癌放疗后局部复发诊断中的应用[J].湘南学院学报(医学版),2012,14(2):25-27.
[19]钟贻洪,李金高,钟俊远,等.磁共振表观扩散系数对鼻咽癌放疗后复发与纤维化的鉴别诊断价值[J].实用癌症杂志,2013,28(3):288-291.
[20]林蒙,余小多,赵燕风,等.扩散加权成像表观扩散系数预测鼻咽癌同步放化疗疗效[J].中国医学影像技术,2014,30(7):986-990.
[21]王琛,苏丹柯,刘丽东,等.MR扩散加权成像对鼻咽癌患者局部复发的诊断价值[J].中华放射学杂志,2014,48(6):476-479.
[22]何汇朗,刘辉明,许森奎,等.MR扩散加权成像预测鼻咽癌放疗预后的价值[J].中华放射学杂志,2017,51(1):13-17.
[23]郭笑寒,孔祥林,田兴仓,等.扩散加权成像对鼻咽癌放化疗疗效的预测价值[J].临床放射学杂志,2017,36(1):28-33.
[24]SIMO R,ROBINSON M,LEI M,et al.Nasopharyngeal carcinoma:United Kingdom National Multidisciplinary Guidelines[J].J Laryngol Otol,2016,130(2):S97-103.
[25]MOHANDAS A,MARCUS C,KANG H,et al.FDGPET/CT in the management of nasopharyngeal carcinoma.[J].Am J Roentgenol,2014,203(2):146-157.
[26]ZHOU H,ZHOU Y,LI L.Meta-analysis of 18F-FDGPETCT for diagnosis of residual/recurrent nasopharyngeal carcinoma after radiotherapy[J].Eur Nucl Med Mol I,2015,42(1):S606-607.
[27]陈韵彬,毛瑜,潘建基,等.鼻咽癌弥散加权成像临床研究[J].中华放射肿瘤学杂志,2009,18(2):88-91.
[28]侯毅斌,王忠富,陈国硕,等.中短期鼻咽癌放疗随访中磁共振扩散加权成像的应用价值[J].中国CT和MRI杂志,2015,13(6):8-9.
[29]徐继飞,王凡.磁共振成像在鼻咽癌放射治疗中的应用[J].国际肿瘤学杂志,2012,39(2):127-130.
[30]YILDIRIM I O,EKICI K,DOGAN M,et al.Can diffusion weighted magnetic resonance imaging(DW-MRI)be an alternative to 18F-FDG PET-CT(18 F-fluorodeoxyglucose positron emission tomography)in nasopharyngeal cancers?[J].Biomed Res,2017,28(9):4255-4260.
[31]YEN R F,HUNG R L,PAN M H,et al.18-fluoro-2-deoxyglucose positron emission tomography in detecting residual/recurrent nasopharyngeal carcinomas and comparison with magnetic resonance imaging[J].Cancer,2003,98(2):283-287.
[32]马美,杜晓东.18氟-脱氧葡萄糖正电子发射断层扫描显像对鼻咽癌复发早期的诊断价值[J].国际耳鼻咽喉头颈外科杂志,2013,37(1):51-53.