Solitary pulmonary nodules: Meta-analytic comparison of cross-sectional imaging modalibes for diagnosis of malignancy
Solitary pulmonary nodules: Meta-analytic comparison of cross-sectional imaging modalibes for diagnosis of malignancy
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DOI：
10.1148/radiol.2463062148
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发表时间：
2008-03-01
期刊：
影响因子：
19.7
通讯作者：
Carlos, Ruth C.
中科院分区：
文献类型：
--
作者：
Cronin, Paul;Dwamena, Ben A.;Carlos, Ruth C.
目的：进行一项荟萃分析，以评估动态对比材料增强计算机断层扫描（CT）和磁共振（MR）成像、氟18氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）和锝99 m（Tc-99 m）脱碘单光子发射计算机断层扫描（SPECT）对孤立性肺结节（SPN）的诊断准确性。材料和方法：数据来源于1990年1月至2005年12月期间在PubMed上发表的研究。选择的研究是比较性和非比较性诊断队列研究，以检查用于评估SPN的四种成像方式的操作特征，涉及至少10例经组织学证实的入组受试者，并有足够的数据计算列联表。使用以测试结果为条件的疾病概率的随机系数二元回归模型来总结测试性能并构建总结受试者工作特征（ROC）曲线。灵敏度，特异性，预测值，诊断优势比，ROC曲线下面积calculated.Results：四十四项研究-10动态CT，6动态MR，22 FDG PET，和7 Tc-99 m-depreotide SPECT-符合纳入标准。(One FDG PET和SPECT组均纳入研究。）敏感性、特异性、阳性预测值、阴性预测值、诊断优势比和ROC曲线下面积分别为0.93（95%置信区间[CI]：0.88，0.97），0.76（95% CI：0.68，0.97），0.80（95% CI：0.74，0.86），0.95（95% CI：0.93，0.98），39.91（95% CI：1.21，81.04）和0.93（95% CI：0.81，0.97）动态CT; 0.94（95% CI：0.91，0.97），0.79（95% CI：0.73，0.86），0.86（95% CI：0.83，0.89），0.93（95% CI：0.90，0.96），60.59（95% CI：5.56，115.62）和0.94（95% CI：0.83，0.98）对于动态MR; 0.95（95% CI 0.93，0.98），0.82（95% CI：0.77，0.88），0.91（95% CI：0.88，0.93），0.90（95% CI：0.85，0.94），97.3]（95% CI：6.26，188.37）和0.94（95% CI：0.83，0.98）FDG PET：和0.95（95% CI：0.93，0.97），0.82（95% CI：0.78，0.85），0.90（95%（10.83，0.97），0.91（95% CI：0.84，0.98），84.50（95% CI：34.28，134.73）和0.94结论：动态CT、ME、FDGPET、99 m-Depreotide SPECT对鉴别SPN的良恶性具有无创性、准确性高的特点;这些测试之间的差异是不显著的。
Purpose: To perform a meta-analysis to estimate the diagnostic accuracy of dynamic contrast material-enhanced computed tomography (CT) and magnetic resonance (MR) imaging, fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET), and technetium 99m (Tc-99m) depreotide single photon emission computed tomography (SPECT) for evaluation of solitary pulmonary nodules (SPNs).Materials and Methods: Data, sources were studies published in PubMed between,January 1990 and December 2005. The selected investigations were comparative and noncomparative diagnostic cohort studies to examine the operating characteristics of the four imaging modalities for evaluation of SPNs, involving at; least 10 enrolled participants with histologic confirmation and having sufficient data to calculate contingency tables. A random coefficient binary regression model with disease probability conditioned on test results was used to summarize test performance and construct summary receiver operating characteristic (ROC) curves. Sensitivities, specificities, predictive values, diagnostic odds ratios, and areas under the ROC curve were calculated.Results: Forty-four studies-10 dynamic CT, six dynamic MR, 22 FDG PET, and seven Tc-99m-depreotide SPECT-met the inclusion criteria. (One study was included in both the FDG PET and SPECT groups.) Sensitivities, specificities, positive predictive Values, negative predictive values, diagnostic odds ratios, and areas under the ROC curve were, respectively, 0.93 (95% confidence interval [CI]: 0.88, 0.97), 0.76 (95% CI: 0.68, 0.97), 0.80 (95% Cl: 0.74, 0.86), 0.95 (95% CI: 0.93, 0.98), 39.91 (95% CI: 1.21, 81.04), and 0.93 (95% CI: 0.81, 0.97) for dynamic CT; 0.94 (95% CI: 0.91, 0.97), 0.79 (95% CI: 0.73, 0.86), 0.86 (95% CI: 0.83, 0.89), 0.93 (95% CI: 0.90, 0.96), 60.59 (95% Cl: 5.56,115.62), and 0.94 (95% CI: 0.83, 0.98) for dynamic MR; 0.95 (95% CI 0.93, 0.98), 0.82 (95% CI: 0.77, 0.88), 0.91 (95% CI: 0.88, 0.93), 0.90 (95% CI: 0.85, 0.94), 97.3] (95% CI: 6.26,188.37), and 0.94 (95% CI: 0.83,0.98) for FDG PET: and 0.95 (95% CI: 0.93, 0.97), 0.82 (95% Cl: 0.78, 0.85), 0.90 (95% (1 0.83, 0.97), 0.91 (95% CI: 0.84, 0.98), 84.50 (95% CI: 34.28, 134.73), and 0.94 (95% CI: 0.83, 0.98) for Tc-99m-depreotide SPECT.Conclusion: Dynamic CT and ME, FDG PET, and Tc-99m-depreotide SPECT are noninvasive and accurate in distinguishing malignant from benign SPNs; differences among these tests are nonsignificant..