Esophageal cancer: CT, endoscopic US, and FDG PET for assessment of response to neoadjuvant therapy - Systematic review
Esophageal cancer: CT, endoscopic US, and FDG PET for assessment of response to neoadjuvant therapy - Systematic review
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DOI：
10.1148/radiol.2363041042
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发表时间：
2005-09-01
期刊：
影响因子：
19.7
通讯作者：
Sloof, GW
中科院分区：
文献类型：
--
作者：
Westerterp, M;van Westreenen, HL;Sloof, GW
目的：通过对文献的系统回顾，比较计算机断层扫描(CT)、超声内窥镜(US)和18氟脱氧葡萄糖(FDG)正电子发射断层扫描(PET)对食道癌患者新辅助治疗反应的诊断准确性。材料和方法：检索Medline和EMBASE数据库及Cochrane系统评价数据库。两名评价者独立评估了每项研究的方法学质量。结果：4篇CT研究、13篇超声内窥镜研究、7篇FDG PET研究符合纳入标准。方法学质量满分的百分比从15%到100%不等。总结ROC分析可用于三项CT研究、四项内窥镜超声研究和四项FDGPET研究。CT、超声内窥镜和FDGPET的最大联合灵敏度和特异度分别为54%、86%和85%。CT的准确性明显低于FDG PET(P<；.006)和超声内窥镜(P<；.003)。FDGPET与内窥镜超声的准确度相近(P=.839)。在所有患者中，CT总是可行的，而6%的患者CT不可行，FDGPET不可行的比例低于1%。结论：CT对食管癌新辅助治疗疗效的评估准确性较差。内窥镜超声和FDGPET具有同等好的准确性，但在化疗和放疗后，封闭超声并不总是可行的。FDGPET似乎是评估食道癌患者新辅助治疗的一种有前途的非侵入性工具。(C)RSNA，2005年
PURPOSE: To compare diagnostic accuracy of computed tomography (CT), endoscopic ultrasonography (US), and fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) for assessment of response to neoadjuvant therapy in patients with esophageal cancer by using a systematic review of the literature.MATERIALS AND METHODS: MEDLINE and EMBASE databases and Cochrane Database of Systematic Reviews were searched for relevant studies. Two reviewers independently assessed the methodological quality of each study. Summary receiver operating characteristic (ROC) analysis was used to summarize and compare the diagnostic accuracy of the three modalities.RESULTS: Four studies with CT, 13 with endoscopic US, and seven with FDG PET met inclusion criteria. Percentages of the maximum score in regard to methodological quality ranged from 15% to 100%. Summary ROC analysis could be performed for three studies with CT, four with endoscopic US, and four with FDG PET. The maximum joint values for sensitivity and specificity were 54% for CT, 86% for endoscopic US, and 85% for FDG PET. Accuracy of CT was significantly lower than that of FDG PET (P < .006) and of encloscopic US (P < .003). Accuracy of FDG PET and that of encloscopic US were similar (P = .839). In all patients, CT was always feasible, whereas encloscopic US was not feasible in 6% of the patients, and FDG PET was not feasible in less than 1%.CONCLUSION: CT has poor accuracy for assessment of response to neoadjuvant therapy in patients with esophageal cancer. Endoscopic US and FDG PET have equivalent good accuracy, but encloscopic US is not always feasible after chemotherapy and radiation therapy. FDG PET seems to be a promising noninvasive tool for assessment of neoadjuvant therapy in patients with esophageal cancer. (c) RSNA, 2005